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Paying for Performance -- Sounds Good …. But What Performance Are WE Paying For?

Paying for Performance -- Sounds Good …. But What Performance Are WE Paying For?. Nancy Wolff, Ph.D. Complexities of Co-occurring Conditions Conference, June 23-25, 2004, Washington D.C. Substance Abuse Tx. Primary. Specialty. Mental Health Tx. Primary. Specialty.

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Paying for Performance -- Sounds Good …. But What Performance Are WE Paying For?

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  1. Paying for Performance -- Sounds Good …. But What Performance Are WE Paying For? Nancy Wolff, Ph.D. Complexities of Co-occurring Conditions Conference, June 23-25, 2004, Washington D.C.

  2. Substance Abuse Tx Primary Specialty Mental Health Tx Primary Specialty Performance Level 1Facility Level Public Funding Private Funding

  3. Target Efficiency • Distribution of Need • Distribution of Services • Distribution of Funding • Which is leading? • Which should lead? • Efficient relative to what? • Demand • Need

  4. Substance Abuse Tx Primary Sustained Client Outcomes Specialty Mental Health Tx Primary Specialty Performance Level 2Client Level Immediate Client Outcomes

  5. Return on Investment • Immediate: Effectiveness of treatment and their combinations • Sustainability: Effectiveness of treatment on recovery

  6. Social Outcomes Increased Productivity Reduced Crime Improved Family Welfare Sustained Client Outcomes Immediate Client Outcomes Performance Level 3Societal Level

  7. Return on Investment • Connection between: • Immediate and Sustained Client Outcomes • Client Outcomes and Treatment • Connection between: • Client and Social Outcomes • Client and Social Outcomes and Other Contextual Factors

  8. Social Outcomes Increased Productivity Reduced Crime Improved Family Welfare Sustained Client Outcomes Immediate Client Outcomes Contextual Factors Performance Level 3Societal Level

  9. Public Funding Substance Abuse Treatment Immediate Client Outcomes Sustained Client Outcomes Mental Health Treatment Private Funding Rewarding Performance Funding Facility Client Societal Social Outcomes

  10. For What Performance are WE Paying ? • Level of performance? • Criteria for performance? • Relationship among the levels? • Effect of contextual factors on client and social outcomes?

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