Support to Advance ROI Assessment
Alliances constructed models they will be able to strengthen with future data. In the absence of timely outcomes data related to programs, Alliances relied on other sources of data. Cincinnati extrapolated behavior change and resulting emergency department utilization from a survey of individuals who accessed the campaign’s Facebook page. Memphis collected service utilization information from patientsthemselves. In the case of Humboldt County, ROI data from existing literature served as proxy for local utilization data. Although these data provide a starting point and enabled ROI analysis, the results would be stronger if true local utilization data could be used by Alliances. Since the models and calculator tools have now been created, the participating Alliances are in a good position to strengthen their ROI calculations in the future with proper data collection.
A negative ROI is an important result. A negative ROI can indicate that a program should be revamped or re-assessed in the context of an organization’s goals. For example, the Maine Alliance found that stakeholders were unwilling to contribute financial resources toward the proposed project. This realization resulted in the Maine Alliance changing course in its program development to better align with stakeholder willingness to pay. Even if a program is already underway, a negative ROI can be informative. Programs with negative ROI’s may still be valuable because of intangible benefits. Helping stakeholders recognize the intangible benefits of a program may increase their willingness to support a program that may present a net financial loss.
Efforts to convey value to stakeholders may require a combined quantitative and qualitative approach. Although stakeholders may prioritize value in financial terms, intangible benefits may be of great value. For example, incorporating patients into an advisory council may benefit the culture of a primary care practice and ensure patient-centered services. But, as noted above, downstream benefit (e.g., costs saved)may be difficult to quantify. Even as efforts to measure quantitative benefit continue, Alliances can strive to communicate a broader definition of benefits to stakeholders beyond financial benefit.
Initial results do suggest positive ROI, particularly for payers. As described above, many of the lessons from the consumer engagement ROI analysis project relate to challenges, limitations, and opportunities to strengthen the analyses moving forward. Nevertheless, five out of the seven participating Alliances were able to show a quantifiable financial benefit to the programs they evaluated. Payers (health plans and employers) are most likely to benefit from programs that seek to reduce avoidable utilization. Alliances unable to show a quantifiable benefit still gleaned important information that will help them focus further program development and evaluation efforts.