Pay-for-performance in a community substance abuse clinic

Ryan Vandrey, Maxine L. Stitzer, Shauna P. Acquavita, Patricia Quinn-Stabile

Research output: Contribution to journalArticlepeer-review


Pay-for-performance (P4P) strategies improve employee productivity and morale in business settings and are increasingly being implemented in medical care settings. This study investigated whether P4P could improve treatment utilization and retention at a community drug treatment clinic. Counselors had the opportunity to earn cash bonuses based on therapy attendance rates of individual clients and on the quarterly retention rates of their caseload. Using a pre-post study design, average therapy sessions attended during the first month of treatment increased from 4.6 sessions prior to the intervention to 5.5 sessions per client during the intervention. The 90-day client retention rate increased from 40% to 53%. Additional analyses suggest that the improvement in the 90-day retention was mediated by the increase in attendance during the first month of treatment. This project demonstrates that implementing a P4P incentive program in community drug abuse treatment clinics is feasible and effective at improving utilization and retention.

Original languageEnglish (US)
Pages (from-to)193-200
Number of pages8
JournalJournal of Substance Abuse Treatment
Issue number2
StatePublished - Sep 2011


  • Contingency management
  • Incentives
  • Pay-for-performance
  • Retention
  • Treatment utilization

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health


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