May 19, 2014 2 Comments
By Michael Connor, Dr.P.H., Senior Vice President, Alere Health and Bruce Sherman, MD, Medical Director, Employers Health Coalition
The Population Health Alliance (PHA) Quality & Research Committee has identified Value on Investment (VOI) as a key initiative for this year. The goal of this work group is to empower purchasers of population health management (PHM) programs to adopt a comprehensive value proposition, which more broadly captures the business impact beyond healthcare costs. Initial objectives include defining the scope of the VOI construct and determining a compelling rationale that is embraced by PHM purchasers.
The Health Enhancement Research Organization (HERO) and PHA led a collaborative effort to develop guidelines related to value domains and corresponding core metrics. The VOI model encompasses all of these domains as outputs as well as a broad view of investment or inputs beyond program vendor fees and incentive costs.
The domains are organizational support, participation, health impact, productivity and performance, financial savings and satisfaction. The Organizational Support domain addresses the degree to which an organization commits to the health and well-being of its employees. Participation recommends measures and definitions related to meaningful program interventions. The Health Impact domain covers measures associated with preventable health conditions. The Productivity and Performance domain provides an employee continuum ranging from absenteeism through optimal performance at work. Financial Health Care Savings incorporates claims data and modeling estimates. Satisfaction addresses participant and provider perspectives.
Initial reactions have been very positive related to both the domains and the VOI approach. Most stakeholders are intrigued with the concept, and some have enthusiastically volunteered to pilot the process. Others have suggested the need to develop a more compelling business case to discuss with purchasers. There are clearly data implications related to a broader set of outcome measures beyond the more traditional and narrower focus of financial health care savings.
Work group discussions have questioned whether organizational support is an outcome or rather an input within the VOI framework. Additional considerations have raised the need for a greater focus on participant program engagement as well as assessing program impact on employee engagement at work and other business outcomes.
So what are your thoughts regarding …
- What are the barriers to a purchaser acceptance of a broader value proposition and how these can be addressed?
- What practical measures and methodologies best assess value components and will be readily adopted?
- How do the value domains align with purchasers’ (employers, health plans and government) strategic priorities?
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