This plenary presentation by Thomas McLellan, PhD explores performance issues within existing specialty care addiction treatment programs, mental health programs and correctional settings. Dr. McLellan discusses sensible methods for using performance management practices in the context of Alberta Health Services’ recent review of systems. He also makes the case that clinically practical goals are needed for the integration of mental health and substance abuse care into the larger system of general health care in Alberta. This presentation was delivered as part of the Recovery from Addiction (RFA) symposium, held in October 2012.