Abstract
Upon undertaking a ROI analysis, multiple aspects should be considered up front. First and foremost, the scope and perspective of the analysis should be determined, as these decisions will inform every subsequent decision about which costs and benefits are relevant and how to quantify and include them. Understanding these initial steps and how they ultimately influence the realized return will provide guidance to individuals and organizations for how to vet and select quality improvement opportunities in light of the resulting ROI . Finally, they will also allow for the most appropriate and effective methods to use to recruit partners, providers, and healthcare systems to participate in desired quality improvement activities.
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Notes
- 1.
Note that this has real implications in value-based and bundled payment systems, as efficiencies and improvements funded by a payer may produce benefit at the provider or facility level that is not directly realized by the payer. We will dive into this concept more deeply in a later chapter.
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One of the benefits of evaluating projects based on their associated value is that it can emphasize the importance of sustainability: Simply maintaining an achieved level of quality can continue to produce monetary benefits indefinitely.
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The need or desire to demonstrate statistical significance in the demonstrated value is uncommon, and such demonstrations are usually limited to changes in measures of quality. A thorough sensitivity analysis of the value calculation is usually sufficient to address uncertainty.
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That is not to say that there may not be hospital benefits : These high utilizers have likely resulted in elevated readmission rates for this hospital which could have imposed monetary penalties. Reductions in their utilization may translate into cost savings for the hospital through reduced readmission-related penalties. To estimate that, however, we would need more information regarding previous financial penalties.
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Solid, C.A. (2020). Initial Steps. In: Return on Investment for Healthcare Quality Improvement. Springer, Cham. https://doi.org/10.1007/978-3-030-46478-3_3
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DOI: https://doi.org/10.1007/978-3-030-46478-3_3
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