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About Washington Circle

Generally, performance measures are designed to establish clear standards of accountability that inspire efforts to improve quality of care. 

The Washington Circle recognizes that development of quality indicators for substance abuse services is a complex task that may differ from other areas of health or mental health.  A number of factors complicate the task:

  • Substance abuse problems often manifest as a range of physical and psychological conditions that require their own treatment or intervention.  Without aggressive screening and case finding, the primary substance abuse problem may go unrecognized and unaddressed.
  • The nature of substance abuse often leads individuals to minimize or dismiss the role of alcohol or drug use in their health or mental health problem.  Substance abuse is a chronic disorder that requires sustained treatment and skillful engagement by the health care provider.
The persistent social stigma associated with the term “alcoholic” or “drug addict,” coupled with the illegal activities that some individuals may commit to sustain drug use, disrupt the traditional relationship between the health care provider and patient.

Background of the WC
Monitoring the quality and availability of alcohol and other drug services must be a central tenet of any health-related performance measurement system.

The Washington Circle has developed a core set of performance measures for alcohol and other drug services for public- and private-sector health plans.

It also is collaborating with a broad range of stakeholders to ensure widespread adoption of these performance measures by health plans, private employers, public payers, and accrediting organizations.


Core Domains for measurement
Recognizing that any measurement approach would be inadequate if it failed to recognize the chronic, relapsing nature of substance use disorders, the WC adopted a process of care model that incorporated four key domains of care: Prevention/Education; Recognition; Treatment; and the Maintenance of Treatment Effects (recently renamed Recovery Support Services).  The WC is committed to developing scientifically rigorous but practical set of measures to evaluate system and provider performance across all four domains.