Medical Home Metrics and Measurements for Achieving ROI

IBM spends about $2 billion a year on healthcare for its 500,000 employees but doesn’t believe it’s getting its money’s worth from the current system, explains George Chedraoui, healthcare leader with IBM and immediate past president of Bridges to Excellence. Chedraoui explains why IBM is banking on the patient-centered medical home (PCMH) — with its focus on disease prevention and wellness — to deliver this value, what impact $19 billion in health IT incentives will have on physician practices, and why it will take more than technology to transform a physician practice into a medical home.

Aetna’s practice of sending its providers periodic “care considerations” — detailed clinical data that identify opportunities to improve care — has been formalized in its patient-centered medical home (PCMH) pilot with Partners in Care (PIC), explains Dr. Don Liss, the regional medical director of Aetna’s mid-Atlantic region. PIC providers’ engagement with the care considerations is now a factor in the pay for performance aspect of the pilot. Dr. Liss shares some short-term indicators that demonstrate that the PCMH is working as well as the long-term view for medical home ROI, which can vary greatly for payors and providers.

Chedraoui and Dr. Liss shared different viewpoints — the healthcare payor and purchaser — and their strategies for achieving an ROI from the medical home during, Medical Home Metrics and Measurements for Achieving ROI.

George Chedraoui

Length: 9:12 minutes
Dr. Don Liss

Length: 11:49 minutes

Calculating the Health Coaching ROI: Models and Results

According to Paul Terry, Ph.D., president and CEO of StayWell Health Management, when evaluating health coaching and population health programs, it is rare to see a return on investment in a program’s first year, but generally by the second and third years, ROI begins to build. In addition to discussing ROI trends, Terry evaluates the value of self-reported data and the impact health coaching can have on an organization’s productivity, presenteeism and absenteeism, and also gives some benchmarks for ROI in health coaching.

Terry, along with Dr. Craig Nelson, director of health services research for American Specialty Health, described the measures to look at when evaluating health coaching and population health programs and provided case studies of how they are actually using these measures to demonstrate a health management ROI during a March 25, 2009 webinar, Calculating the Health Coaching ROI: Models and Results.

Length: 7:12 minutes