Institute for Behavioral Health

Schneider Institutes for Health Policy

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Research

    Select Research Projects

    • Brandeis/Harvard NIDA Center to Improve the Quality of Drug Abuse Treatment

      National Institute on Drug Abuse (NIDA)

      Constance Horgan (PI), Richard Frank (Co-PIs), Sharon Reif, Vanessa Azzone, Tom McGuire, Terri White, Daley M, Garnick DW, Gittell J, Hodgkin D, Merrick EL, Reif S, Ritter GA, Shepard DS, Tompkins C

      The Brandeis/Harvard NIDA Center fosters a synergistic approach to drug abuse and addiction research. The Center's current theme is refined from a generic focus on managed care to a second generation of studies that examine the question: What elements of organization, management, financing and payment in a managed care environment make a difference in effective drug abuse service delivery? In particular, how can incentives within these areas be used to encourage or support the provision of quality drug abuse treatment services?

    • Clinician Characteristics and Substance Abuse Performance Measures

      National Institute on Drug Abuse (NIDA)

      Sharon Reif (PI), Constance Horgan, Elizabeth Merrick, Maria Torres

      To improve quality of treatment, performance measurement is increasingly being used. So far, performance measures for substance abuse services measure the status of individual clients, typically aggregated to the level of health plans or treatment facilities. However, in privately funded treatment, individual office-based clinicians are key providers of care. Little research has examined the relationship between clinician characteristics and aggregate performance for treatment of substance use disorders.  In addition, treatment for substance use disorders under private insurance has been under-explored along a number of dimensions, including quality. By focusing on the role of clinician characteristics in performance measures, this study can contribute to the understanding of how to improve the quality of substance abuse treatment. Therefore, we aim to identify specific clinician characteristics that are associated with better performance, and thus higher quality treatment of substance use disorders, within the context of private health plans. 

    • Collection of Economic Data for the Prescription Opioid Addiction Treatment Study

      (POATS Supplement; CTN-0030)

      National Institute on Drug Abuse (NIDA)

      Cindy Thomas, Don Shepard, Sharon Reif

      The supplement collected data necessary for economic analyses associated with the Prescription Opioid Addiction Treatment Study (POATS) (CTN-0030), a multi-center Clinical Trials Network (CTN) study assessing the incremental value of drug counseling and two durations of buprenorphine-naloxone (bup-nx) for patients with opioid analgesic dependence. POATS hypothesizes that adding more intensive individual counseling to standard medical management will improve treatment outcomes for this population, both in a relatively brief taper treatment and in a longer treatment with bup-nx. However, it is unclear whether any and how much benefit will be gained, and at what cost. EMM is clearly a more complex and expensive treatment approach than SMM.

    • Coordinating Primary Care and Substance Abuse Treatment Services (Gurewich/RWJ)

      Robert Wood Johnson Foundation (RWJF)

      Deborah  Gurewich (PI), Jeff Prottas, Don Shepard, Deborah Garnick, Galina  Zolotusky, Jenna Sirkin 

      The study seeks to address three research aims: 1) To determine the organizational arrangements community health centers adopt for coordinating primary care and substance abuse (SA) treatment services; 2) To determine the relative success of these different approaches for coordinating primary care and SA treatment services; 3) To understand how especially effective CHC models for coordinating primary care and SA treatment services achieve their success.

    • Effects of Deployment on the Health of Military Dependents

      Department of Health and Human Services (DHHS) - PS (Subcontract to CDM Group)

      Mary Jo Larson (PI), Jennifer Perloff, Grant Ritter, Chris Tompkins, Beth Mohr, Sue Lee, Rachel Adams

      This contract seeks to measure, evaluate and analyze the effects of service member deployment on the healthcare utilization of family members, using TRICARE Management Activity data. 

    • The Effect of Parity Legislation on Substance Abuse Treatment

      National Institute on Drug Abuse (NIDA)

      Richard Frank (PI), Vanessa Azzone

      A pilot study supported through the Brandeis/Harvard NIDA Center on Drug Abuse Treatment. The aims of this study are to examine the impact of parity for substance abuse treatment on the cost of substance abuse care and on indicators of the quality of substance abuse treatment.

    • Evaluation of the Closing the Addiction Treatment Gap (CATG) Initiative

      Open Society Institute (OSI)

      Mary Jo Larson (PI), Mary Brolin, Gail Strickler, Margot Davis, Beth Mohr, Elizabeth  Fischer, Andrea Acevedo, Deborah  McLellan, Angela Walter, Amity Quinn

      This project assists the Open Society Institute by conducting and disseminating an ongoing process and outcomes evaluation of a national initiative involving 8 states to develop and implement financing, efficiency, and communication strategies to make addiction treatment to increase financing of addictions treatment and enroll more people into care.

    • Health Related Quality of Life Impacts of Illness on Family and Caregivers

      National Institute of Nursing Research (NINR)

      Eve Wittenberg (PI), Don Shepard, Gail Strickler, Grant Ritter, Galina Zolotusky

      This study will assess how chronic illness affects parents, spouses, and family members of an affected individual, and how to accurately measure these effects so that they can be considered in decisions.  The ultimate goal of this research is to expand the definition of health to include a family- or household-level focus rather than an individual-level one, and to consider public health interventions from this perspective.

    • Management Evidence-Based Practices in Substance Abuse Treatment

      Robert Wood Johnson Foundation (RWJF)

      Constance Horgan (Co-PI), Sharon Reif (Co-PI), Jon Chilingerian, Christopher Tompkins, Maria Torres, Hannah Karpman

      This project aims to better understand the relationship between management practices and the performance of substance abuse treatment organizations. The broad underlying hypothesis is that better managed organizations, in combination with the use of effective clinical practices, achieve better overall outcomes. Our goal is to identify these evidence-based management practices in order to complement ongoing work in developing a consensus around evidence-based clinical practices in substance abuse treatment.

    • National Prescription Monitoring Program Center of Excellence

      U.S. Department of Justice

      Peter Kreiner (PI),  Carol Prost, Cindy Thomas, MeeLee Kim, Lee Panas, Ruslan Nikitin

      Funded through a training and technical assistance grant from DOJ's Bureau of Justice Assistance (BJA), the Center will assist prescription drug monitoring programs (PMPs), now authorized in 41 states and the U.S. Territory of Guam, by providing useful and timely data on prescriptions to doctors, pharmacies, and regulatory agencies. The Center will develop an informational clearinghouse and help to identify best practices in prescription monitoring, while serving as a forum to exchange ideas and foster partnerships that increase PMP effectiveness.

    • Profiling and Incentives in Behavioral Health Care

      National Institute on Drug Abuse (NIDA)

      Chris Tompkins (PI), Don Shepard, Marilyn Daley, Richard Frank, Constance Horgan

      This study aims to understand methods and incentives that can be used to improve the quality of substance abuse treatment. Specifically, it aims to (1) Determine whether provider profiling has a positive impact on provider performance, client outcomes and costs;  (2)  Determine whether a package of incentives from the state agency to substance abuse treatment providers further improves provider performance, client outcomes and costs; (3) Determine the impact of profiling and incentives on the costs and outcomes of substance abuse treatment for vulnerable treatment sub-populations (e.g., women, minorities and those with dual diagnoses of substance abuse and mental health problems); and (4) Estimate agency and client level factors that are associated with providers' ability to achieve and maintain successful levels of performance, and to identify other on-going changes that also affect performance.

    • Research Supplement to Promote Diversity in Health-Related Research

      National Institute on Drug Abuse (NIDA)

      Robert Dunigan (PI), Marilyn Daley, Sharon Reif, Don Shepard, Jennifer Perloff

      The major goal of the supplement is to evaluate the contribution of profiling and incentives in improving managed behavioral health care for minority general assistance clients, who receive substance abuse treatment under the state of Connecticut's managed behavioral health care program. Understanding the impact of profiling and incentives on providers serving minority clients is vital for understanding the causes and factors associated with disparities in treatment outcomes, and for the development of more effective intervention strategies aimed towards marginalized populations.

    • The Role of Customization in Psychotropic Prescribing

      National Institute on Mental Health (NIMH)

      Dominic Hodgkin (PI), Elizabeth  Merrick, Constance Horgan, Grant Ritter, Lee Panas, Sue Lee, Galina Zolotusky

      Poor adherence to psychotropic medications is a pervasive problem, which could potentially be reduced by better matching of medications to patients (customization). This research seeks to measure the extent of customization and see how it relates to treatment adequacy, outcomes and costs.

    • Substance Abuse Performance Measures and Narcotics Anonymous Group Participation

      National Institute on Drug Abuse (NIDA)

      Gail Strickler (PI), Sharon Reif, Constance Horgan

      Using data from the Alcohol and Drug Services Study (ADSS), a national sample of specialty substance abuse treatment facilities and clients discharged from those facilities, we aimed to:  1) Describe the characteristics of clients discharged from specialty substance abuse treatment facilities who attended addiction-related mutual help groups after treatment; 2) Determine the relationship between four during-treatment substance abuse performance measures and subsequent mutual help aftercare.  Performance measures were based on indicators designed or under development by the Washington Circle and include engagement in treatment, retention in treatment and two measures of maintenance of treatment effects; and 3) Adjust the samples for potential selection bias using propensity score methods and revise results accordingly. 

    • Substance Abuse Treatment Pathways for Employee Groups

      National Institute on Drug Abuse (NIDA)

      Elizabeth Merrick (PI), Constance Horgan, Dominic Hodgkin, Tom McGuire

      A key issue in facilitating access to substance abuse treatment is to understand the pathways by which individuals may enter treatment. In the private sector, employees and their dependents often have multiple options in terms of pathways to specialty treatment, including managed behavioral health care (MBHC) carve-out plans and employee assistance programs (EAPs) - both of which may be provided by the same managed behavioral health organizations (MBHOs). This study, a component of the Brandeis/Harvard Center on Managed Care and Drug Abuse Treatment, offers the opportunity to investigate the interrelationships in utilization patterns and costs among MBHC, EAP, and other resources for substance abuse problems, via administrative data and an enrollee survey.

    • Substance Abuse Treatment and Work

      National Institute on Drug Abuse (NIDA)

      Richard Frank (PI), Tom  McGuire, Constance Horgan, Sharon Reif

      This research, conducted by Harvard Medical School's Department of Health Care Policy as part of the Brandeis/Harvard NIDA Center, explores the design of payment incentives for programs that seek to offer services to support labor market entry for income support program participants with substance abuse disorders. Our primary interest is in the factors associated with return to successful employment. We study the characteristics of beneficiaries, how these relate to return to work, and how this favorable outcome is related to program organization and financing.

    • Washington Circle Supplement

      National Institute on Drug Abuse (NIDA)

      Deborah Garnick (PI), Margaret Lee, Elizabeth Merrick

      This supplement consists of three focuses: (1) the implementation of the Public Sector Project which works with 10 states to adapt the Washington Circle (WC) substance abuse performance measures to the public sector; (2) provide technical support to the WC; and (3) collaborate with the Forum by supporting consumer perception of care specifications and pilot testing them for substance use disorders.

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