Quantifying the Value of Value-Based Purchasing

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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.