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Hands-on Tool Training: Asthma Return on Investment (ROI) calculator

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On January 17, 2008, Rosanna Coffey and Ginger Carls provided Hands-on Tool Training for the Asthma Return on Investment (ROI) Calculator at the State Healthcare Quality Improvement Workshop. This is the text version of the event's slide presentation. Please select the following link to access the slides: (PowerPoint® file, 780 KB; PDF File, 160 KB; PDF Help).

Slides: 1 | 2 | 3 | 4 | 5 | 6 | 7


Slide 1: Hands-on-Training: Potential uses of the Asthma Care ROI calculator

Ginger Smith Carls, M.A., Rosanna M. Coffey, Ph.D. , Ronald J. Ozminkowski, Ph.D., Karen Ho, M.S., Mika Nagamine, Ph.D., Katheryn Ryan

January 17-18, 2008
State Healthcare Quality Improvement Workshop:
Tools You Can Use to Make a Difference

On the top of the slide are the logos for the Department of Health & Human Services and the AHRQ logo. The Department of Health & Human Services logo is an artistic image of an eagle with the outlined profile of faces. The AHRQ logo reads, "AHRQ — Agency for Healthcare Research and Quality: Advancing Excellence in Health Care, www.ahrq.gov."

This presentation uses a template with a blue background and a header with the AHRQ and Department of Health & Human Services logos on the left.

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Slide 2: Examples

  • Planning
  • Evaluation

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Slide 3: Planning Example: Use calculator to estimate impact of program on Medicaid budget

  • Objective: forecast budget impact of proposed asthma care program
  • Data available
      — Obtained from Medicaid claims
    • Asthma prevalence rates (from Medicaid claims)
    • Utilization of medical care services (from Medicaid claims)
        — Obtained from pilot study
    • Change in utilization rates, but impact on medications and ancillary services not available
        — Other info
    • 10 year planning horizon
    • Program costs $100 a year for each person that participates
  • Missing information
      — Cost of Medical care services
      — Impact of program on medical costs and ancillary services

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Slide 4: Planning Example

Changes to each page of the calculator

  • Population
      — Medicaid
      — State (Arizona this example)
      — No need to adjust age, gender and race since using own prevalence rates
  • Participants
      — Adults and Children
      — Severity - persistent asthma
      — Change number eligible based on own data (10,000)
      — Participation rate (60%)
  • Baseline
      — Change cost perspective to program /plan (exclude patient payments)
      — ED visits for asthma: 0.5 per year per patient
      — Hospital stays for asthma: 0.1 per year per patient
      — Outpatient (office visits) for asthma: .9
  • Program Impact from pilot study (used a control group)

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Slide 5: Program Impact

This slide contains a screenshot of the Program Impact page from AHRQ's Asthma ROI calculator. The page shows the impact estimates from a meta-analysis of the research literature on asthma quality improvement and disease management. Both healthcare measures, such as program impact on emergency department visits, and productivity measures, such as program impact on missed work days per adult, can be assessed using this tool.

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Slide 6: Results

This slide contains a screenshot of the Results page from AHRQ's Asthma ROI calculator. The page shows the impact of the asthma program and summarizes prior assumptions made in the calculator. Two decisions must be made on this page: 1) Whether to include health care savings, productivity gains, or both. 2) Whether to report results per participant or per program.

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Slide 7: Evaluation Example: Use calculator to guide or compare

  • Objective: Plan evaluation of asthma intervention and monitor impact before and after evaluation finished
  • Plan comprehensive evaluation:
      — Are all components captured? (Inpatient, emergency, outpatient, medication, ancillary tests)
      — What is time horizon of expected program costs and returns?
      — Are future benefits and costs evaluated on a discounted (equalized) time horizon?
      — Are productivity gains assigned financial returns?
  • Monitor impact of intervention
      — Early results without a control group - compare to studies without a control group
      — Controlled results in - compare to controlled studies
      — Find studies that evaluated same type of intervention

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