Quantifying the Value of Value-Based Purchasing

描述（由申请人提供）：本申请旨在支持在亚特兰大和芝加哥开展的创新健康和工作效率示范项目的成本效益评估，该项目由这些市场的雇主商业和健康联盟（佐治亚州医疗保健领导委员会和中西部健康商业集团）与健康和生产力管理研究所以及哈佛医学院的研究人员合作。亚特兰大-芝加哥健康和生产力示范项目的干预措施将以扩大对已知对工作绩效有影响、已知治疗不足以及已知对现有干预措施有反应的常见健康问题（例如肥胖、流感、腰痛、季节性过敏）的服务为特色。将通过比较治疗费用的变化与从年度雇员健康和生产力跟踪调查中获得的工作绩效货币化衡量指标的变化来评估成本效益。当前应用程序的目的是在三个方面扩大对这种干预的评估。首先，我们的目标是扩大数据收集工作，将来自调查的个人层面数据与三种类型的行政数据（健康计划福利数据；个人层面的药房和健康索赔数据；以及关于次优工作表现、病假和残疾的个人层面客观工资记录）整合起来。其次，我们的目标是扩展数据分析，从雇主的角度对雇主在扩大的员工医疗保健方面的投资在多大程度上具有成本效益进行严格的准实验前后病例对照评估。第三，我们的目标是建立一个持续的质量保证监控系统，供雇主用来跟踪其医疗投资的回报。这些目标的成功完成将产生关于基于价值的雇主医疗保健购买的成本效益的独特数据，并创建一个实用的质量保证系统，以鼓励雇主进一步投资于工人健康。

DESCRIPTION (provided by applicant): This application seeks support for an evaluation of the cost-effectiveness of an innovative health and work productivity demonstration project carried out in Atlanta and Chicago by the employer business and health coalitions in those markets (the Georgia Healthcare Leadership Council and the Midwest Business Group on Health) in collaboration with the Institute for Health and Productivity Management and researchers from Harvard Medical School. The intervention in this Atlanta-Chicago Health and Productivity (ACHP) demonstration project will feature expanded services for commonly occurring health problems that are known to have effects on work performance, that are known to be under-treated, and that are known to be responsive to existing interventions (e.g., obesity, flu, low back pain, seasonal allergies). Cost-effectiveness will be evaluated by comparing changes in treatment costs with changes in monetized measures of work performance obtained from annual employee health and productivity tracking surveys. The aims of the current application are to expand the evaluation of this intervention in three ways. First, we aim to expand the data collection effort to integrate individual-level data from the surveys with administrative data of three sorts (data on health plan benefits; individual-level pharmacy and health claims data; and individual-level objective payroll records on sub-optimal work performance, sickness absence, and disability). Second, we aim to expand data analysis to carryout rigorous quasi-experimental before-after case-control evaluations of the extent to which investments by employers in expanded employee healthcare are cost-effective from the employer perspective. Third, we aim to create an ongoing system of quality assurance monitoring that can be used by employers to track their returns on healthcare investments. Successful completion of these aims will generate unique data on the cost-effectiveness of value-based employer healthcare purchasing and create a practical quality-assurance system to encourage further employer investments in worker health.