Lessons Learned from Alliances’ ROI Assessments
Alliances need assistance to understand ROI. Understanding the process and framework for conducting an ROI analysis can be difficult, particularly for organizations unaccustomed to thinking of their services in monetary terms. Initial proposals revealed some gaps in proposers’ understanding of the ROI methodology. This finding prompted the National Program Office to pair the grant funding with structured technical assistance.
The technical assistance process revealed some other challenges. While Alliances were easily able to identify the broader topic area for the analysis (e.g., the ROI of a patient coaching program), they needed to work through the analysis’ specific objective and primary purpose. For example, the Memphis Alliance knew it wanted to investigate its patient coaching program’s ROI. The framework the Alliance initially proposed, however, mixed the purpose of appealing to practices to participate with the goal of approaching payers for program funding and investment. Upon further reflection, Memphis decided payers were the primary audience. Memphis’ experience was similar to those of other Alliances—moving from the initial proposal to a solid framework for analysis took time and assistance. Alliances worked to ensure both the costs and benefits being measured accrued to the same stakeholder group.
Technical assistance can help build capacity for ROI assessment. The National Program Office offered the grantees structured technical assistance—a series of four webinars, combined with individual consultation—to facilitate more robust ROI analyses and build the Alliances’ capacity. In addition to providing expert instruction and a structured process, the webinars provided opportunities for grantees to learn from one another. Although the project presented a steep learning curve for some Alliances, both the technical assistance and learning-by-doing proved fruitful. The Alliances’ final reports demonstrated an increased understanding of the ROI framework. Although ROI analysis can be challenging, technical assistance can enhance analytical capacity.
Quantifying program costs is both a step in the ROI analysis process and valuable stand-alone knowledge. For many grant-funded programs, the costs of a given program are contained within a larger program budget. An early step in assessing a program’s ROI is to quantify its costs. Alliances had generally not previously quantified program costs in this way. ROI analysis also helped Alliances understand what results or outcomes would be needed (e.g., number of emergency department visits averted) to break even or to realize a positive ROI. In the case of a membership model, the Alliance was able to quantify the value of the services the members receive. For example, Washington calculated the cost of the materials and support member employers received through the Own Your Health employee education program. The ROI process helped demonstrate the value of membership. Quantifying costs is an important stand-alone tool for future analyses.