What Might P4P in Addiction Treatment Look Like?

The October issue of Fast Company reports on a hospital network that offers fixed price coronary artery bypass (CABG) surgery at a fixed price with a 90-day "any complications and your surgery is free."

One aspect of their model: a standardized checklist of 40 steps from pre-surgery through recovery that medical personnel must sign off on. (Doctors can elect to skip a step, but they must document that they're skipping the step.)

Another aspect of the model: the price charged includes a fraction of the expected costs of follow-up care usually associated with complications. If a surgery usually costs $50,000 and follow-up procedures might cost $10,000, a fraction of that $10,000 is built into the new list price for the surgery for all patients (say, $50,800).

Some questions to think about:

• What might such a model look like for adolescent substance abuse treatment?
  
• How is substance abuse treatment different from surgery?
  
• Are those differences barriers to such a strategy?
  
• Could some differences enhance the utility of this model for substance abuse services?
  
• How is the checklist different from procedures and standards set by accrediting organizations?