Quantifying the Value of Value-Based Purchasing

描述(由申请人提供)：本申请寻求支持对亚特兰大和芝加哥两个市场的雇主企业和健康联盟(佐治亚州医疗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和哈佛医学院的研究人员合作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进行评估。亚特兰大-芝加哥健康与生产力(ACHP)示范项目中的干预措施将扩大针对常见健康问题的服务，这些问题已知会影响工作表现，已知治疗不足，以及已知对现有干预措施(例如肥胖、流感、下腰痛、季节性过敏)有反应。将通过比较治疗费用的变化与通过年度雇员健康和生产力跟踪调查获得的工作业绩货币化措施的变化来评估成本效益。目前申请的目的是通过三种方式扩大对这一干预措施的评估。首先，我们的目标是扩大数据收集工作，将调查中的个人一级数据与三类行政数据(健康计划福利数据；个人一级药房和健康索赔数据；以及关于次优工作表现、疾病缺勤和残疾的个人一级客观工资记录)整合在一起。其次，我们的目标是扩大数据分析，从雇主的角度对雇主在扩大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试验性病例对照前后评估。第三，我们的目标是创建一个持续的质量保证监控系统，雇主可以使用该系统来跟踪他们在医疗保健投资中的回报。成功完成这些目标将产生关于基于价值的雇主医疗保健采购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.