Association Between Intensity and Timing of Specialty Palliative Care and Hospice Exposure With Quality of End-of-Life Care.

Gaps remain in our understanding of the intensity and timing of specialty palliative care (SPC) exposure on end-of-life (EOL) outcomes. Examine the association between intensity and timing of SPC and hospice (HO) exposure on EOL care outcomes. Data for this cohort study were drawn from 2021 adult decedents from Kaiser Permanente Southern California and Colorado ( = 26,251).

Improving quality and performance in substance use treatment programs: What is being done and why is it so hard?

Summary: As states plan to implement system-wide change of any kind, it is important to understand program directors' perspectives on challenges they face. This is especially true with quality improvement reforms. Much research has focused on quality improvement in medicine, but there is a gap in our knowledge about programs that treat individuals with drug or alcohol use.

Incentives in a public addiction treatment system: Effects on waiting time and selection.

Program-level financial incentives are used by some payers as a tool to improve quality of substance use treatment. However, evidence of effectiveness is mixed and performance contracts may have unintended consequences such as creating barriers for more challenging clients who are less likely to meet benchmarks. This study investigates the impact of a performance contract on waiting time for substance use treatment and client selection.