Quantifying the Value of Value-Based Purchasing

描述（申请人提供）：本申请寻求对亚特兰大和芝加哥的雇主商业和健康联盟开展的创新性健康和工作生产力示范项目的成本效益评估的支持（格鲁吉亚州医疗保健领导理事会和中西部医疗保健商业集团）与健康与生产力管理研究所和哈佛医学院的研究人员合作。这个亚特兰大-芝加哥健康和生产力（ACHP）示范项目的干预措施将为已知会影响工作绩效、已知治疗不足以及已知对现有干预措施（例如，肥胖、流感、腰痛、季节性过敏）。将通过将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业绩货币化衡量标准的变化进行比较来评估成本效益。本申请的目的是以三种方式扩大对这种干预的评价。首先，我们的目标是扩大数据收集工作，将调查中的个人层面数据与三类行政数据（健康计划福利数据;个人层面药房和健康索赔数据;以及个人层面关于次优工作表现、病假和残疾的客观工资记录）相结合。其次，我们的目标是扩大数据分析，以进行严格的准实验性的前后病例对照评估，从雇主的角度来看，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。第三，我们的目标是建立一个持续的质量保证监测系统，雇主可以使用它来跟踪他们在医疗保健投资上的回报。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.