Incentives for Improving Aims (IIA)

In IIA systems, states work closely with providers to develop a set of performance targets related to specific aims. Most often, the targets are related to improvements in one of the four NIATx aims. Depending on the structure of the system, providers will receive monetary incentives for meeting or exceeding the targets.

The state of Maine utilized the PDSA approach to implement an IIA system for its providers. After evaluating the implementation of their incentive system, Maine found that STAR-SI agencies engaged in NIATx process improvement efforts were more likely to achieve their incentive targets than agencies not engaging in process improvement efforts.

Learn how they designed and implemented the system:

In fiscal 2002, the Delaware Division of Substance Abuse and Mental Health (DSAMH) replaced their traditional cost-reimbursement contracts with performance-based contracts. The new system was designed to improve the accountability and effectiveness of clinical services for all state outpatient addiction treatment programs. A study of the effect of that system on treatment quality can be found at (McLellan et al., 2008).

Iowa has been offering provider incentives through its contract with Magellan. In the 2005-06 incentive plan, developed by Department of Public Health (DPH) and Magellan, providers receive a base incentive amount . This amount was determined using information from the state SARS/I-SMART system. Additional funds were made available to providers who improved retention in treatment as measured by length of stay. Take a look at an example of the letter Add to portal send to providers explains more about the system.