This Core Center of Excellence application (P30) for the renewal of the Brandeis/Harvard Center to Improve System Performance of Substance Use Disorder Treatment proposes to enhance the effectiveness and impact of existing research on delivery and payment of substance use disorder (SUD) treatment services, and offer a national resource for those researching and designing SUD treatment systems and policy in the context of ongoing, dramatic changes in the US health care system. The Center’s goal is to conduct and extend research on service delivery and payment to synergistically expand the research base, informing policy and practice decisions that will profoundly affect the cost, quality, and availability of SUD services. The intertwined nature of delivery and payment systems requires attention to both in order to achieve sustainability of high value systems innovations. While continuing to emphasize innovations in delivery and payment systems broadly defined, the proposed renewal will also bring intentional focus to low-barrier settings for treatment (i.e., wholly outside of or extensions of specialty SUD settings such as emergency departments, pharmacies, and telehealth), as well as quality improvement, inequities in the provision and financing of services, and factors that influence sustainability of innovation. The renewal also will expand the science around Medicaid managed care, given the importance of Medicaid as a payer of SUD services, and the dominant role of private Medicaid health plans. The Center will build on three Component research projects, as well as related research at Brandeis, Harvard and elsewhere, and support the development of new research to provide crucial and timely evidence that can inform the design and implementation of effective policy and practice. The Administrative, Research, Policy/Dissemination, and Pilot/Mentoring Cores provide the organizational engine to promote cross-fertilization of findings across projects to support the Center’s aims: 1) advance the science by conducting and stimulating research and knowledge development about payment and delivery system innovation for SUD treatment; 2) drive the next generation of research by mentoring and training a racially/ethnically diverse pool of early career investigators and creating networks of early career and senior researchers; and, 3) engage with key stakeholders in a bidirectional exchange to produce timely and relevant research that informs and influences policy and practice. The Center will achieve these aims by extending the research base to include critical analyses of timely and emerging topics identified in close collaboration with key stakeholders. We will do this through activities that include empirical and conceptual papers; short- and longer-term analyses targeted at pressing issues for policy and practice; and multiple mentoring programs and activities to support early career investigators. Further, we will translate and disseminate findings to...