Presentation on the planned cost analysis of the NEAIC intervention by Robin Clark, PhD. (Presented at the annual meeting of the New England Asthma Innovations Collaborative, June 13, 2013, Shrewbury, MA)

1. Evaluating the Impact of
NEAIC Interventions on
Healthcare Costs
Robin Clark, PhD
Director of Research & Evaluation
Center for Health Policy & Research

2. What are the ideal questions?
Did NEAIC interventions improve
children’s health?
How did NEAIC interventions affect
healthcare costs?
How much did it cost to improve health
outcomes?

3. Compared to what?
• Doing nothing?
• Another new treatment?
• Treatment as usual?

4. Types of Economic Evaluations
•
•
•
•
Cost-effectiveness
Cost benefit
Return on investment
Cost

5. Types of Economic Evaluations
Cost-effectiveness
Cost benefit
Compare change in
costs and change in
outcomes
Return on
investment
Compares change in
cost
Cost
Measures change in
cost

6. Cost-effectiveness is preferred
…. but it requires cost and outcome data
for a comparison group
cost comparisons can be derived from
medical claims

7. Return on Investment Analysis:
Healthcare Payer Perspective
Intervention Group
Comparison Group
Healthcare Costs
Healthcare Costs
Difference
Change
Change
Before
After
Before
After

8. What costs are included?
• The cost of the NEAIC intervention
• The cost of other healthcare that study
participants used
• Measured from a public insurer
perspective

9. Creating a comparison group
1. Use Medicaid claims to identify a group
of children with asthma who are similar
to the intervention group
2. Match the groups on demographics,
diagnoses, clinical risk and service use
history
3. Create a 1 to 1 or 1 to 2 match.

10. Why bother?
• A comparison group helps answer the
question “What would have happened if
we had not intervened?”
• Helps to rule out some alternative
explanations for change (e.g. regression
to the mean.)

11. Other possibilities:
• Collect original outcome data for a
comparison group (expensive)
• Derive hypothetical change measures
from another study with a similar
population (some challenges)