What Do You Know About Health Quality Measures for Opioid Use Disorder?
Tools that assess care can help fill gaps in treatment

To improve treatment for opioid use disorder (OUD), it is essential to assess care delivery using quality measures—tools that help measure or quantify health care processes, outcomes, and more. Yet although many states track overdose deaths, most are not reporting data on the effectiveness of treatment or the use of medications for OUD—the most effective form of treatment. In recognition of National Healthcare Quality Week, Oct. 16-22, see how much you know about this issue.
- Quality measures are tools that help evaluate _____
- Health care processes and outcomes
- Patient perceptions of their care
- How health care systems are organized
- All of the above
Quality measures can be used to incentivize and improve provider performance through value-based payments, help policymakers monitor the effectiveness of their treatment systems, identify racial and ethnic disparities in care so that health systems and states can address these gaps, and help patients choose high-quality treatment options.
- One organization sets the gold standard for health care quality measurement in the United States.
- True
- False
The National Quality Forum (NQF) is a nonprofit organization that convenes diverse stakeholders in medicine, health insurance, government, and other fields to review quality measures with a set of standard evaluation criteria. If a measure meets these criteria, it is considered “endorsed,” meaning that it meets the gold standard for measuring health quality.
- There is a preferred framework of care for OUD—from diagnosis to initiation, retention, and recovery. What is this course of action called?
- Point of care
- Warm handoff
- Cascade of care
- Rehabilitation
Despite increasing opioid overdose deaths, problems persist in the availability and quality of treatment for OUD. Adoption of the OUD Cascade of Care framework to assess the treatment system and identify gaps could help state policymakers improve system-level practice and treatment outcomes. The “cascade” includes the following stages:
- OUD identification or diagnosis: Having a formal diagnosis of OUD in a medical record or claim.
- Initiation of OUD treatment: Receiving medication.
- Retention in OUD treatment: Engaged in OUD treatment for at least six months.
- Recovery: Defined by the Substance Abuse and Mental Health Services Administration as “a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential.”
- What proportion of U.S. states are publicly reporting OUD treatment metrics?
- 1/3
- 3/4
- None
- All
Although many states have opioid dashboards and data tracking opioid overdoses within their borders, as of summer 2021, Pew found that just 16 states publicly reported OUD treatment-related metrics, such as rates of initiation and engagement with medications for OUD, treatment provider capacity, and patient-reported outcomes associated with treatment. States that aren’t measuring treatment can’t improve the number of people who receive it. Therefore, it’s important that state officials track and report more data so they can identify gaps and make plans to improve care.
- What percent of adults with Medicaid begin treatment for OUD within two weeks of diagnosis?
- 15%
- 40%
- 55%
- 80%
The quality measure initiation and engagement in opioid use disorder treatment shows that on average, 55% of people with Medicaid coverage between the ages of 18-64 began treatment within 14 days of a diagnosis. But research shows that only 30% stayed in care for more than a month. Some states are using this measure in value-based payments to inform efforts that help improve treatment outcomes. For instance, in Oregon, coordinated care organizations that serve people with Medicaid can receive incentive payments if they improve performance on this measure.
- Medication treatment for OUD should always be short term.
- True
- False
Long-term treatment can lead to better outcomes in employment, health, and criminal justice involvement. In fact, the Centers for Medicare and Medicaid Services’ quality measure continuity of pharmacotherapy [medications] for OUD evaluates whether people are staying in care for at least six months.
- In the OUD Cascade of Care, there is no validated measure for ________
- OUD identification or diagnosis
- Initiation of OUD treatment
- Retention in OUD treatment
- Recovery
Although policymakers need to understand whether treatment is improving patients’ quality of life, there is currently no validated measure for recovery. However, there are assessment tools, such as the Brief Assessment of Recovery Capital and the Recovery Capital Index, that can be used to understand the progress that people with OUD are making in achieving their goals. Pew recommends that state policymakers adopt a recovery assessment tool and test strategies to collect and report the data.
{passfail} You got {score} out of {total_questions}. Thanks for testing your quality measure smarts!

Substance Use Prevention and Treatment
Exclusive state-policy research, infographics, and stats every two weeks.


States Should Measure Opioid Use Disorder Care
The most effective treatments for opioid use disorder (OUD) are medications: methadone, buprenorphine, and naltrexone. However, there are substantial gaps between the number of people who need these medications and those who receive them, and the United States continues to experience a devastating number of lives lost to the opioid epidemic.


How States Can Measure Effectiveness of OUD Care
Over the past year, drug overdose deaths in the United States have hit record levels, with the Centers for Disease Control and Prevention reporting more than 100,000 fatalities between April 2021 and April 2022. An equally troubling statistic, though, is that most people with opioid use disorder (OUD) who would benefit from lifesaving therapies—that is, FDA-approved medications, including methadone, buprenorphine, and naltrexone—do not receive them.
Don’t miss our latest facts, findings, and survey results in The Rundown