Abstract
Objective: To illustrate the impact of key quasi-experimental design elements on cost savings measurement for population health management (PHM) programs. Data Sources: Population health management program records and Medicaid claims and enrollment data from December 2011 through March 2016. Study Design: The study uses a difference-in-difference design to compare changes in cost and utilization outcomes between program participants and propensity score-matched nonparticipants. Comparisons of measured savings are made based on (1) stable versus dynamic population enrollment and (2) all eligible versus enrolled-only participant definitions. Options for the operationalization of time are also discussed. Data Collection/Extraction Methods: Individual-level Medicaid administrative and claims data and PHM program records are used to match study groups on baseline risk factors and assess changes in costs and utilization. Principal Findings: Savings estimates are statistically similar but smaller in magnitude when eliminating variability based on duration of population enrollment and when evaluating program impact on the entire target population. Measurement in calendar time, when possible, simplifies interpretability. Conclusion: Program evaluation design elements, including population stability and participant definitions, can influence the estimated magnitude of program savings for the payer and should be considered carefully. Time specifications can also affect interpretability and usefulness.
| Original language | English (US) |
|---|---|
| Journal | Health Services Research |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
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Keywords
- Attrition
- Cost savings
- Intention-to-treat
- Population health management
- Program evaluation
ASJC Scopus subject areas
- Health Policy
Cite this
Key Design Considerations When Calculating Cost Savings for Population Health Management Programs in an Observational Setting. / Murphy, Shannon M.E.; Hough, Douglas Earle; Sylvia, Martha; Dunbar, Linda J.; Frick, Kevin.
In: Health Services Research, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Key Design Considerations When Calculating Cost Savings for Population Health Management Programs in an Observational Setting
AU - Murphy, Shannon M.E.
AU - Hough, Douglas Earle
AU - Sylvia, Martha
AU - Dunbar, Linda J.
AU - Frick, Kevin
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Objective: To illustrate the impact of key quasi-experimental design elements on cost savings measurement for population health management (PHM) programs. Data Sources: Population health management program records and Medicaid claims and enrollment data from December 2011 through March 2016. Study Design: The study uses a difference-in-difference design to compare changes in cost and utilization outcomes between program participants and propensity score-matched nonparticipants. Comparisons of measured savings are made based on (1) stable versus dynamic population enrollment and (2) all eligible versus enrolled-only participant definitions. Options for the operationalization of time are also discussed. Data Collection/Extraction Methods: Individual-level Medicaid administrative and claims data and PHM program records are used to match study groups on baseline risk factors and assess changes in costs and utilization. Principal Findings: Savings estimates are statistically similar but smaller in magnitude when eliminating variability based on duration of population enrollment and when evaluating program impact on the entire target population. Measurement in calendar time, when possible, simplifies interpretability. Conclusion: Program evaluation design elements, including population stability and participant definitions, can influence the estimated magnitude of program savings for the payer and should be considered carefully. Time specifications can also affect interpretability and usefulness.
AB - Objective: To illustrate the impact of key quasi-experimental design elements on cost savings measurement for population health management (PHM) programs. Data Sources: Population health management program records and Medicaid claims and enrollment data from December 2011 through March 2016. Study Design: The study uses a difference-in-difference design to compare changes in cost and utilization outcomes between program participants and propensity score-matched nonparticipants. Comparisons of measured savings are made based on (1) stable versus dynamic population enrollment and (2) all eligible versus enrolled-only participant definitions. Options for the operationalization of time are also discussed. Data Collection/Extraction Methods: Individual-level Medicaid administrative and claims data and PHM program records are used to match study groups on baseline risk factors and assess changes in costs and utilization. Principal Findings: Savings estimates are statistically similar but smaller in magnitude when eliminating variability based on duration of population enrollment and when evaluating program impact on the entire target population. Measurement in calendar time, when possible, simplifies interpretability. Conclusion: Program evaluation design elements, including population stability and participant definitions, can influence the estimated magnitude of program savings for the payer and should be considered carefully. Time specifications can also affect interpretability and usefulness.
KW - Attrition
KW - Cost savings
KW - Intention-to-treat
KW - Population health management
KW - Program evaluation
UR - http://www.scopus.com/inward/record.url?scp=85041645197&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85041645197&partnerID=8YFLogxK
U2 - 10.1111/1475-6773.12832
DO - 10.1111/1475-6773.12832
M3 - Article
C2 - 29417572
AN - SCOPUS:85041645197
JO - Health Services Research
JF - Health Services Research
SN - 0017-9124
ER -