Much has been made about promoting the use of so-called evidence-based practices derived from research studies. In some cases, reimbursements are tied to documentation that such practices are used. Some “evidence” might be based on arbitrary metrics that while scientifically sound is largely irrelevant to the real world. This presentation will make the case that routine monitoring of treatment outcomes is a necessary strategy whether evidence-based practices are employed. Providers can consider either internal monitoring or contracting with commercially available external outcomes monitors. How providers can make decisions about establishing outcomes-based practices will be discussed.