Metrics
Develop strategies to measure the impact of and improve the quality of OUD services before, during, and after incarceration
Why is this important?
There is little information available for assessing the process of delivering OUD care or the impact of delivering OUD care to Medicaid beneficiaries before and after release from correctional facilities.
Furthermore, while national and state organizations have developed reentry OUD metrics, these are not Medicaid specific. However, at the federal level, CMS is developing measures for Reentry 1115 Demonstration Waivers.
Strategy
States will want to know whether efforts to serve individuals with OUD before and during reentry are having the intended impact. SMAs should consider developing a concise set of measures for OUD care that can be used to assess impact.
Steps for designing measurement efforts
After identifying an appropriate set of measures, states can consider taking these steps:
- Develop a data dictionary for the selected measures
- Craft a data use plan that provides policymakers with information to make changes to the Medicaid reentry effort
- Create a strategy for providing feedback to correctional facilities, community providers, and MCOs about the quality of OUD services
These measures can serve as the basis for the monitoring protocol and reports that states will submit to CMS.
Example #1: HARP’s list of reentry measures
HARP has developed a list of measures to evaluate OUD services for individuals before and after reentry — including measures based on Medicaid reentry initiatives.
Example #2: Kentucky
The Commonwealth of Kentucky received approval for the monitoring protocol for their 1115 Reentry Demonstration. This document sets forth both quantitative and qualitative measures for this demonstration.
Read: Kentucky Reentry 1115 Demonstration Monitoring Protocols, pages 3–26
Example #3: New York
New York’s Department of Health has developed a toolkit to support MOUD implementation in correctional facilities. This toolkit provides an evaluation strategy and also cites several measures for correctional reentry initiatives.
Access: Medication for Opioid Use Disorder (MOUD): Correctional Health Implementation Toolkit, page 40
Example #4: Kentucky
The Criminal Justice Kentucky Treatment Outcome Study provides information for states to consider for developing their own monitoring protocols for pre- and post-release outcomes.
Explore: CJKTOS: Criminal Justice Kentucky Treatment Outcome Study
Example #5: Allegheny County, Pennsylvania
Allegheny County has developed a dashboard to track metrics on MOUD provision to individuals pre-release and outcomes post-release, like overdose deaths and utilization of health care services.
Check out: Medication for Opioid Use Disorder (MOUD) in Allegheny County Jail (ACJ) Dashboard
Example #6: Santa Clara County, California
Santa Clara County Custody Health Services has collected and analyzed initial measures to leverage early lessons to inform and strengthen implementation across correctional facilities across California. These initial measures focus on:
- The extent to which individuals are actively shaping the goals in their reentry plans
- Efficient processes before release, such as case conferences
- Tracking release dates and whether individuals receive a 30-day supply of medications (including MOUD) at release
Read: Report from Custody Health Services Relating to Operational Updates