Value Drivers: An Approach for Estimating Health and Disease Management Program Savings

Abstract

Health and disease management (HDM) programs have faced challenges in documenting savings related to their implementation. The objective of this eliminate study was to describe OptumHealth's (Optum) methods for estimating anticipated savings from HDM programs using Value Drivers. Optum's general methodology was reviewed, along with details of 5 high-use Value Drivers. The results showed that the Value Driver approach offers an innovative method for estimating savings associated with HDM programs. The authors demonstrated how real-time savings can be estimated for 5 Value Drivers commonly used in HDM programs: (1) use of beta-blockers in treatment of heart disease, (2) discharge planning for high-risk patients, (3) decision support related to chronic low back pain, (4) obesity management, and (5) securing transportation for primary care. The validity of savings estimates is dependent on the type of evidence used to gauge the intervention effect, generating changes in utilization and, ultimately, costs. The savings estimates derived from the Value Driver method are generally reasonable to conservative and provide a valuable framework for estimating financial impacts from evidence-based interventions.

Development of a wellness trust to improve population health: Case-study of a United States urban center

“…The narrative review on cost-effectiveness of prevention initiatives was limited as most research has focused on targeted health conditions. In total, 33 studies on cost-effectiveness were reviewed: systematic reviews (n = 9) ( Baicker et al, 2010 ; Chapman, 2012 ; Edwards et al, 2013 ; Goetzel et al, 2005 ; Grosse et al, 2007 ; Korczak et al, 2011 ; Krause, 2005 ; Mattke et al, 2007 ; Weatherly et al, 2009 ), observational studies (n = 13) ( Ahn et al, 2015 ; Billings and Mijanovich, 2007 ; Brown, 2014 ; Diaz et al, 2015 ; Hung et al, 2007 ; Linden, 2006 ; Mays and Smith, 2011 ; Ormond et al, 2011 ; Phillips et al, 2013 ; Schwartz et al, 2010 ; Thorpe and Yang, 2011 ; Wang et al, 2003 ; Zhuo et al, 2012 ), randomized controlled trials (n = 2) ( Ackermann et al, 2008 ; Holmes et al, 2008 ), white papers (n = 4) ( Levi et al, 2010 ; Institute on Urban Health Research and Practice, 2013 ; Chen et al, 2016 ; Schmidt et al, 2012 ), and perspective pieces (n = 5) ( Baxter, 2010 ; Brush, 2013 ; Bodenheimer, 2003 ; Jacobs, 2012 ; Russell, 2009 ). This literature revealed that: 1) clinical settings are not as cost-effective as community-based settings, 2) while programs can be cost-effective, they are rarely cost-saving, and 3) extended time horizons are suitable for prevention programming as benefits (and costs) may not be realized for some time.…”