Founded in 2003, NIATx works with behavioral health care organizations across the country to improve access to and retention in treatment for the millions of Americans with substance abuse and/or mental health issues.
NIATx is part of the University of Wisconsin–Madison's Center for Health Enhancement Systems Studies (CHESS).
NIATx was formerly the acronym for the Network for the Improvement of Addiction Treatment. Now, we're known simply as NIATx. This reflects our growth and expansion into fields other than addiction treatment.
NIATx facilitates peer networking and provides research, case studies, and innovative tools that encourage use of our process improvement model. This model is quality-driven, customer-centered, and outcome-focused, and has proven effective in transforming members' business practices and the quality of care their clients receive.
NIATx initiatives work to improve consumer outcomes and advance behavioral health as an essential component of the health care system. Each new project builds upon the success of an earlier one, yielding rich information on how process improvement can transform single organizations as well as complex systems.
NIATx resulted from the unique collaboration of two national initiatives: Paths to Recovery, funded by the Robert Wood Johnson Foundation (RWJF); and Strengthening Treatment Access and Retention (STAR), funded by the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT). Both initiatives focused on improving systems and processes and on increasing the rates at which Americans receive and continue through addiction treatment.
Paths to Recovery provided 26 treatment centers with expert coaching, peer learning, support groups, and process improvement techniques using the NIATx rapid-cycle change model. The STAR program worked with 13 providers in 13 states to accomplish three primary goals: implement access and retention “best practices” in community-based treatment organizations; demonstrate the use of quality improvement methods to implement those best practices; and demonstrate the use of access and retention performance measures for monitoring progress. Between 2003 and March 2006, providers in Paths to Recovery and STAR made dramatic improvements in reducing no-shows and wait times and increasing admissions and continuation in treatment.
Having worked successfully with treatment organizations, NIATx leaders recognized that states, as payers for treatment services, could have a profound impact on addiction treatment by removing barriers and providing incentives. As a result, NIATx established the State/Payer Pilot Project. In this pilot, supported by CSAT and RWJF, payers and providers came together to identify how five single state agencies in Delaware, Iowa, North Carolina, Oklahoma, and Texas could be leaders in improving treatment quality; how states and other payers could work with providers to improve access and retention; and how organizations disseminate innovative practices to improve quality of services. The agencies participating in the pilot took major steps forward in showing the country how states and providers could partner to make an impact. The participating states also began to use the NIATx process improvement model to change state regulations and policies affecting access and retention.
Funded by CSAT and RWJF and expanding on the State Pilot Project, STAR-SI helped states improve access and retention in outpatient (OP) treatment centers, which provide 80 percent of addiction treatment services. Grantee states included Florida, Illinois, Iowa, Maine, Montana, New York, Ohio, Oklahoma, South Carolina, and Wisconsin. Over three years beginning in late 2006, the ten state-provider partnerships used a NIATx diffusion model to accomplish four goals: build state capacity to improve access and retention; build payer/provider partnerships that drive the improvement process; implement payer improvement strategies; and implement performance monitoring and feedback systems.
Advancing Recovery was funded by RWJF and co-directed by the Treatment Research Institute, also launched in 2006. In two rounds of funding, the program awarded grants to payer/provider partnerships in Alabama, Arkansas, Colorado, Delaware, Florida, Kentucky, Maine, Maryland, Missouri, Rhode Island, Texas, and West Virginia. These innovative partnerships worked to remove barriers to the implementation of evidence-based practices to treat addiction. Grantees tried to improve practices in at least two of these categories: medications, continuing care/aftercare, and psychosocial therapies. By examining state- and provider-level practices that impede the use of evidence-based care, the Advancing Recovery program aimed to improve consumer outcomes and highlight addiction treatment as an essential component of the health care system.
In Innovations for Recovery, a partnership between NIATx and RWJF, a group of researchers identified ways that emerging communications technology could help people struggling with addiction. Innovations for Recovery created prototypes to demonstrate the potential of these technologies and is developing them to transform the addiction treatment and recovery field through the Addiction CHESS Project: Developing and Testing a Computer-based Alcohol Use Disorder Recovery System. This randomized clinic trial will develop and test a mobile phone-based relapse-prevention system that offers support to alcohol dependent people when and wherever it is needed.
In 2007, NIATx launched the first clinical trial that examines process improvement in addiction treatment. NIATx 200, funded by the National Institute on Drug Abuse, brought together 200 treatment providers from five states, Massachusetts, Michigan, New York, Oregon and Washington, to study NIATx strategies to improve treatment quality, operations, and finances. Each of the 200 providers was randomly assigned to a study arm that used at least one of the following NIATx services: Learning Sessions, Interest Circles, Coaching, and a Web site. The study will help determine which combinations of collaborative services produce the greatest and most economic improvement in achieving the four NIATx aims: reducing wait times and no-shows, and increasing admissions and continuations.
NIATx also launched the ACTION Campaign in 2007 in partnership with more than a dozen other national organizations, foundations, and government agencies. With funding from CSAT and RWJF, the goal of the Campaign was to help at least 500 treatment agencies try any or all of 12 NIATx practices to provide rapid access to treatment, increase client engagement, or provide a seamless transition from one level of care to another. With no cost to participate, the Campaign offered an informative web site, a monthly newsletter, and bimonthly tutorial calls. The Campaign exceeded its recruitment goal, with nearly 1000 agencies participating by the end of the Campaign.
The success of the first Campaign inspired NIATx to offer the ACTION Campaign II: Financial Strength in a Changing World, in Fall 2009. This 18-month project challenges treatment agencies nationwide to test NIATx practices proven to improve both customer service and the financial health of the organization.
In the NIATx model of process improvement, a continuous flow of ideas among peers inspires and motivates organizations to experiment and test changes. Inspiring and motivating one another, NIATx members are building a national movement to extend process improvement throughout the field of behavioral health. With a focus on the customer, NIATx organizations create a community of learners—payers, providers, policy makers—all working toward a common goal.