Payer Readiness for Technology Implementation (P-RTI) Tool Application and Assessment (Wisconsin)

Substance use disorders (SUDs) are widespread chronic diseases. Twenty-four million Americans suffer from them, while only 4 million receive addiction treatment. Those who suffer from an untreated addiction disorder die on average 22.5 years earlier than those without such a diagnosis, and their total costs to society exceed $600 billion annually. Telemedicine provides opportunities to increase access to addiction services, but uptake of this modality has been slow, and is disproportionally less for underserved populations.

Payment policy is a key factor in provider behavior: the willingness of a payer to approve and pay for a procedure has large influence on provider practice. Health information technology (IT) adoption research lacks models that define the factors that influence payer behavior with the same clarity as models explaining the factors that influence individual and organizational health IT adoption behaviors. An explanatory model of the role payers and regulators play in health IT adoption would clarify the payers’ role and begin to broaden the scientific and practical knowledge of this poorly understood area.

This project will test the Payer Readiness for Technology Implementation (P-RTI) assessment tool developed at the University of Wisconsin’s Center for Health Enhancement Systems Studies (CHESS). The focus will be on payer readiness for the adoption of two patient-centered health technologies that can improve addiction treatment: (1) telephonic based therapy, which can result in greater substance use abstinence than in-person therapy; and (2) video-to-video therapy, which increases access to SUD services; performs as well as face-to-face visits; and is preferred by patients because of convenience and confidentiality.

The specific aims of this project are as follows:

• Develop strategies to increase use of telemedicine technologies capable of improving addiction treatment quality and access 
• Determine the level of interest in different patient-centered health IT for addiction treatment and recovery 
• Determine ways to improve diffusion of evidence-based telemedicine applications from research into real-world practice 

The P-RTI tool will be analyzed using a mixed methods approach to compare nine States’ readiness for health IT implementation, against the percentage of patients who receive clinical services from the targeted technologies. The primary outcome measure for the project will be the percentage of patients per treatment organization receiving telephonic therapy or video therapy.