Increase Financial Strength

Improvements in waiting time, no-shows, admissions, and continuation have been shown to translate directly onto the balance sheet. The Acadia Hospital in Bangor, Maine, for example, was able to more than double the number of admissions it handled per month, with a direct translation into net contribution to margin.

A similar business impact has been demonstrated by NIATx members for each of the aims we target. Another facility, for example, changed to a walk-in appointment system; with the resulting increase in admissions, it increased annual fees by more than $300,000.

We make these connections because we know that economics drive an organization’s ability to offer services. A positive economic position is a better leverage point for clinical and/or organizational change. Programs that drain resources from the organization are rarely expanded.

The specific four aims targeted by NIATx were based on research by the Washington Circle, a multi-disciplinary group of providers, researchers, managed care representatives, and public policy makers. This group pilot-tested a core set of performance measures for addiction treatment services, which show that access to and retention in treatment are the greatest predictors of successful recovery.

The four aims support the NIAx conviction that:

• Any interruption or delay in a patient’s smooth entry into and progress through the treatment system represents a serious threat for exacerbation in this chronic illness.
• To maximize access and retention, treatment organizations must redesign work systems.
• Most treatment agency staff are committed to their jobs, but their work can be frustrating and stressful. Inefficiencies in administrative and clinical practices combine with low pay to create low job satisfaction and high turnover. High turnover makes it difficult to invest in training as the solution to the field’s challenges, since the expertise leaves with the employee.
• The NIATx process improvement model considers staff another customer group. Involving staff in Change Projects and requesting their reactions to and advice about improvements helps addiction treatment agencies implement changes that meet their staff’s unique needs.
• Efficient administrative practices that reduce delays, facilitate the patient’s entry into the system, minimize stress and task complexity, and maximize rewards to staff improve quality service and staff job satisfaction.

Business Case Resources

• The Business Case Series
• The Business Case Technical Assistance Report
• Business Case Simulator
• No Show Tool