Addiction is a chronic disease that can be treated effectively. But the use of treatments proven to work varies greatly among treatment facilities. 

Many areas of healthcare use indicators (measures of a given health topic), quality measurement systems, and websites that bring transparency and information on treatment quality to the public. But there is no such system for addiction treatment.

This information is vital to helping individuals or their loved ones make informed decisions about the best care to meet their needs.

To fill this gap, ATLAS aims to:

• Assess the severity and risk of a person’s substance use disorder and produce guidance on the appropriate treatment type based on their unique needs.
• Develop quality standards for addiction treatment facilities across
  • all treatment types—such as outpatient, inpatient, and residential; and
  • different types of services—such as behavioral therapy and medication.
• Promote the use of treatments that are shown to work. 
• Track and support quality improvement in addiction treatment

Some tools can help you find addiction treatment facilities based on your location and your personal preferences or needs, such as your insurance plan or the specific substance misused. But ATLAS is the first and only platform that also assesses and displays quality measures for addiction treatment. This allows you to can compare facilities and choose the one that meets your needs without guessing if the facility is offering the right kind of care.

Currently, ATLAS includes specialty addiction treatment facilities that are

• listed in the Substance Abuse and Mental Health Services Administration (SAMHSA) Behavioral Health Services Treatment Locator (which pulls from a list of National Survey of Substance Abuse Treatment Services respondents), or
• licensed or otherwise recognized by a state as a specialty addiction treatment facility. 

Specifically, ATLAS assesses specialty addiction treatment facilities identified as offering withdrawal management (also known as detox), or addiction treatment (services that focus on initiating and maintaining an individual’s recovery from substance misuse and preventing relapse).
 
Currently, ATLAS does not include

• halfway houses or recovery homes that do not provide addiction treatment;
• individual practitioners, including those who prescribe buprenorphine*; or
• jails, prisons, or other organizations that treat incarcerated clients exclusively.

*In West Virginia, ATLAS will include care using medications for addiction treatment based in offices listed under a name other than that of an individual provider in order to better capture the treatment landscape in this state, while avoiding reporting on individual providers.
 

ATLAS reports information on specialty addiction treatment facilities by their physical location.

ATLAS does not report information on individual providers. 

However, claims-based measures are reported at the parent-organization level, rather than the specific physical location. An organization with multiple facilities will have the same claims-based measure values. 

No. While ATLAS includes some information specific to the treatment of opioid use disorder, it reports on the quality of treatment for all substance use disorders.

ATLAS is currently available in ten states: Delaware, Florida, Louisiana, Massachusetts, New Jersey, New York, North Carolina, Oklahoma, Pennsylvania, and West Virginia. These states were selected based on several criteria, including their readiness for the successful implementation of ATLAS and their demonstrated potential to grow and sustain this platform. 

ATLAS will be expanded to more states until it is available nationwide.

Do you want ATLAS in your state? See how you can get involved.

ATLAS will always be free to people who are seeking addiction treatment for themselves or a loved one.

In the future, ATLAS may require membership fees for certain professional audiences (such as health insurance companies), with the goal of developing a self-sustaining system. However, even if ATLAS is funded by certain professional audiences, Shatterproof is committed to making sure ATLAS remains free for addiction treatment facilities so that it does not become a “pay-to-play” quality system.

ATLAS is a great resource for:

• People seeking addiction treatment for themselves or a loved one
• Addiction treatment providers
• Payers (such as public and private health insurance providers or employers)
• Policymakers and state governments
• Referral sources (such as drug courts and guidance counselors)
• Researchers 

ATLAS benefits:

• The public by helping individuals seeking addiction treatment for themselves or a loved one navigate to treatment facilities delivering high-quality care, based on the Shatterproof National Principles of Care©. Note: This does not replace a consultation with a health care provider to determine the appropriate course of care.
• Treatment providers by giving them the opportunity to:
  • compare the services and operations at their facility with other facilities throughout their state,
  • engage in improving the quality of care, and
  • inform patients of their services and practices.
    • Providers may be able to leverage their participation in the ATLAS system to secure value-based payments and other recognitions of high quality from their contracted payers.
• States by providing the necessary quality data on facilities across their state to inform treatment access and other state-based initiatives, such as technical assistance and policy changes to improve the quality of addiction treatment.
• Payers by allowing them to identify, reward, and promote addiction treatment facilities delivering care that is aligned with the proven best practices outlined in the Shatterproof National Principles of Care©, and by helping them ensure that their members can make informed decisions when selecting an addiction treatment facility.
• Researchers by providing them with state- and facility-level data to evaluate the quality of addiction treatment. 

ATLAS was developed by Shatterproof.

Shatterproof is a national nonprofit organization dedicated to reversing the addiction crisis in the United States.

The ATLAS pilot was funded by a coalition of stakeholders:

• Two-thirds of funding comes from Arnold Ventures and the Robert Wood Johnson Foundation.
• One-third of funding comes from a group of seven health insurers: Aetna, a CVS Health Business; Anthem, Inc; Beacon Health Options; Blue Cross Blue Shield of North Carolina; Cigna; Magellan Health; and UnitedHealth Group.

There is no financial cost to treatment facilities to be included in ATLAS. Also, there is no direct cost to the six Phase 1 states, but they are responsible for costs associated with additional promotion and administrative time to partner on Phase 1. Currently, Shatterproof is exploring strategies for the long-term maintenance and growth of ATLAS, with the goal of developing a self-sustaining system.

Health insurers can play an important role in improving the addiction treatment system. Aligning payment practices with tested and proven treatment for substance use disorders is critical for improving access to these services and integrating the addiction treatment system within mainstream health care. Involving health insurers in efforts to improve the quality of addiction treatment is critical, and therefore the Shatterproof team has chosen to work with health insurers to implement ATLAS.

Health insurers have been involved in ATLAS in various ways, including:

• Seven healthcare companies have collectively funded one-third of the pilot: Aetna, a CVS Health Business; Anthem, Inc.; Beacon Health Options; Blue Cross Blue Shield of North Carolina; Cigna; Magellan Health; and UnitedHealth Group. These companies have no governance role in the project.
• These companies, and additional key health insurers in ATLAS states, supported the implementation of ATLAS by informing and analyzing claims-based measures.
• Health insurers, along with state partners, also encouraged the participation of treatment providers in their networks in ATLAS.

Health insurers can also continue to be involved in ATLAS by using the platform to encourage the use of best practices in addiction treatment by providers.

If you would like to receive regular updates about ATLAS, please join our email list.

The ATLAS quality measures were informed by the following six steps:

1. Shatterproof convened a Committee of Experts (the Committee) to review and compile existing national-level measures and crosswalk them with the Shatterproof National Principles of Care©. 
2. Shatterproof and RTI identified the possible strategies for accessing data to inform these measures.
3. The Committee followed several criteria for creating a draft measure set, including measuring consistency with the National Principles of Care, duplication, impact, relevance to providers, and ease of collection. 
4. The Committee discussed the measures and received feedback on the draft measure set from key stakeholder groups, including key informant interviews with payers and focus group discussions with providers across all levels of care.
5. In January 2019, the National Quality Forum convened an expert panel strategy session, including addiction treatment experts, medical providers, patient advocates, payers, and data scientists to review the proposed measure set and provide recommendations for its implementation during Phase 1.
6. Following the strategy session, the National Quality Forum held a public comment period during which anyone could submit feedback on the measures. This feedback was incorporated into recommendations for the final measure set for Phase 1.

For further information on how the ATLAS measure set was developed and the current measure set, please watch this webinar.
 

ATLAS uses data from three sources:

• Shatterproof’s Treatment Facility Survey: An online survey administered at the facility level that gathers information on processes, structures, and services. Facilities are asked to complete 12 sections of questions, which align with Shatterproof’s National Principles of Care©. 
• Shatterproof’s Patient Experience Survey: A brief series of multiple-choice questions about the use of treatment practices supported by research and patient perceptions of care. Also included is one open-ended, or free-text, question. The survey is anonymously completed by patients of the addiction treatment facility or a loved one acting as a patient proxy.
• Public and private insurance claims: Four claims-based measures calculated by state Medicaid agencies and commercial health plans that cover a significant number of individuals in ATLAS states. The utility of these measures was rigorously assessed. The measures will not be displayed publicly.

Multiple data sources are used to make sure ATLAS collects as much information as possible on addiction treatment quality.:

Treatment Facility Survey data will be supplied and reported on at the facility level. Data will not be supplied or reported on at the provider level.

ATLAS uses health insurance data, also known as claims data, to assess quality. This comprises information found in medical billing claims forms submitted by facilities to public and private health insurers. The states that partnered with Shatterproof in the ATLAS pilot analyzed Medicaid claims (aggregated and de-identified) to inform the claims-based measures of ATLAS. Additionally, Shatterproof worked with healthcare insurance companies to analyze their data to inform claims-based measures for the commercially insured population.

Quality measures based on insurance claims are being used for the first time in this way as a part of ATLAS and are not available for all facilities. As such, these data are not reported publicly but will be available in ATLAS professional portals.

The behavioral therapies listed in the Treatment Facility Survey are drawn from the National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism lists of proven therapies:

• Cognitive Behavioral Therapy
• Contingency Management/Motivational Incentives
• Community Reinforcement Approach
• Matrix Model
• Motivational Enhancement Therapy
• Twelve-Step Facilitation Therapy
• Family Behavior Therapy
• Mindfulness-Based Relapse Prevention

These behavioral therapies meet the following level of rigor (as of October 2019): Efficacy demonstrated in treating a substance use disorder from at least two independent randomized controlled trials and a large-scale real-world field trial. 

Other behavioral therapies may be used for the treatment of substance use disorders, but they do not yet meet this level of rigor. This does not mean they will not meet this threshold in the future. The ATLAS measures will continue to be updated as more evidence becomes available on effective treatments for addiction.
 

The Treatment Facility Survey has multiple validation checks and requests for verification (see About ATLAS Data for detailed descriptions of the validation activities). For example, at the end of the survey, the CEO or senior leadership of the treatment facility is required to review and sign off to ensure the facility submission is correct. When feasible, data from alternative sources are used to validate self-reported information. Finally, treatment facilities can review their analyzed data and submit corrections during a provider preview period. 

Shatterproof is committed to ensuring accurate and meaningful data are collected from treatment facilities through the Treatment Facility Survey. As part of this process, Shatterproof engaged treatment providers in various settings—such as one-on-one interviews or roundtable discussions—to ensure that the survey is clear, easy to use, and presents as little burden as possible on providers. 

Treatment facilities do not receive a composite quality “score” because this would undermine the complexity of determining high-quality addiction treatment that best meets an individual’s needs. However, the public can compare facilities side-by-side to see how the services offered by each facility differ.

Additionally, ATLAS includes tools to help put the publicly displayed quality measures into context, provide additional information about their importance, and offer insight into what makes for high-quality addiction treatment.

ATLAS includes information reported by patients and their loved ones. Patients and their loved ones may provide feedback on this website by visiting a facility’s profile, clicking the “Leave a review” button, and answering the survey questions.

The survey questions were developed by experts to help understand the quality of care provided at the facility and its use of best practices, and to provide relevant information to people searching for treatment.  

All feedback provided via the Patient Experience Survey is anonymous. Feedback will only be displayed in a facility’s profile when a minimum threshold of 20 responses is met.

If you’re a patient or the loved one of a patient who received care at an addiction treatment facility included in ATLAS, you can leave a review by completing a brief survey on this website. Visit the facility’s profile by searching their name on the homepage, then scroll down and click the “Leave a review” button.

Yes, a family member or friend can provide a review for the patient. This individual should respond to questions using the patient’s point-of-view.

We recognize that people with a substance use disorder may over time see different providers for addiction treatment. People can leave reviews for multiple facilities on ATLAS.

Patient feedback is analyzed and updated every 24 hours. Feedback is subject to natural language processing and content review to screen for potential fraudulent responses. Patient feedback will only appear in a profile once 20 responses have been submitted for the facility.