Tobacco outlets and tobacco use in Baltimore City from 2004 to 2009

Abstract

disciplines. This was particularly timely, given that the substance abuse regulatory agency in NY instituted Ambulatory Patient Groups as their payment methodology. Results: The research found that for: (1) Quality, preimplementation annual medical assessments and annual, 30-day and 90-day multidiscipline assessments were timely for 83% and 70%, 72%, and 42% of cases, respectively. Post-implementation, timeliness was 97% and 96%, 87%, and 70% respectively, all highly statistically significant improvements. Hepatitis C viral load was appropriately performed in 85% of cases pre-implementation and 81% post-implementation; a non-significant difference; (2) Satisfaction, there was no change for patients and a non-significant upward trendpost-implementation for staff; (3) Productivity, there was a decline post-implementation; reaching statistical significance for counselors; and (4) Financial Performance, there was no significant change. The ability to generate monthly reports covering Quality (opiate and cocaine-free status for >80% of patients; HIV viral load suppression; HgbA1c<7 for diabetes mellitus; and BP <140/90 for hypertension); Compliance (timely completion of behavioral and medical assessments; meeting or exceeding state targets for vocational status); and Productivity (all disciplines) resulted in improved performance over time. Conclusions: Our ability to exploit system capabilities to provide timely feedback allowed us to navigate changes in reimbursement and documentation, including changes resulting from the Affordable Care Act. Financial support: Supported by the National Institute on Drug Abuse (R01 DA022030).