Cost Effectiveness Analysis in Health economics

This issue brief summarizes information presented at Cost-Effectiveness Analysis: AnEmployer Decision Support Tool, a web-based seminar at the National Business Groupon Health sponsored by the Agency for Healthcare Research and Quality. Statisticsand figures that are not annotated with a source were presented by the speakers.

A glossary of italicized terms and a bibliography of additional cost-effectiveness resourcesare listed at the end of the brief.

Introduction

Large employers face a challenging future inmanaging health care benefits. Managers have manyprogram and coverage options, but are limited bybudget constraints and data availability.Traditionally, decision-makers have used return oninvestment calculations to help guide theirinvestment choices, but they can also consideranother tool — cost-effectiveness analysis.

Cost-effectiveness analysis (CEA) is a method offinancial evaluation that has gained prominencewithin academic and policy communities in the last20 years. But this methodology can also havebusiness applications as a decision support tool. This

issue brief explains cost-effectiveness analysis, outlines its usefulness to employers,demonstrates how cost-effectiveness relates to corporate strategy, and gives examplesof its applications in health benefits decisions.

August 2004

Table of Contents:

I n t r o d u c t i o n 1Cost-Effectiveness Analysis Basics 2Why Employers Use CEA 3Common Ap p l i c at i o n s 4S t r ategic Implicat i o n s 6Practical Examples 9S t r ategic Tips for Interpreting CEA 1 0Sample A b s t r a c t 1 1Case Studies 1 2C o n cl u s i o n 1 4G l o s s a ry 1 5R e s o u r c e s 1 7R e f e r e n c e s 1 9

ISSUEBriefCenter for Prevention and Health Serv i c e s

Cost-Effectiveness Analysis: An Employer Decision Support Tool

August 2004 ISSUEBrief 2

Cost-Effectiveness Analysis Basics

Cost-effectiveness analysis is a specific type of economic analysis in which all costs arerelated to a single, common effect. Decision makers can use it to compare differentresource allocation options in like terms. A general misconception is that CEA is merely ameans of finding the least expensive alternative or getting the “most bang for the buck.”In reality, CEA is a comparison tool; it will not always indicate a clear choice, but it willevaluate options quantitatively and objectively based on a defined model. CEA wasdesigned to evaluate health care interventions, but the methodology can be used for non-health economic applications as well. It can compare any resource allocation withmeasurable outcomes to any otherresource allocation with measurableoutcomes.

Conducting, Evaluating, andUsing AnalysesIncreasing numbers of analyses areconducted in academia or researchorganizations and published in peer-reviewed journals. Governmentorganizations use analyses to helpshape public policy. Health insurers useCEAs to determine which kinds ofhealth interventions to cover. There isa growing body of work that quantitatively compares the health returned on differentinterventions employers cover in their benefits packages. As employers are increasinglyasking providers to practice evidence-based medicine, they can direct this trend byevaluating and acting on evidence, or by holding health plans and consultants accountablefor evaluation and action.

Cost-effectiveness analysis, or CEA, is a comparison tool to helpevaluate choices. It will not always indicate a clear choice, but it will evaluate optionsquantitatively based on a definedmodel. For managers, CEA provides peer-reviewed evidencefor decision support.

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Cost-Effectiveness RatioThe cost-effectiveness ratio is simply the sum of all benefits divided by the sum of all costs.This is comparable to a return on investment calculation; however, the benefits are notmeasured in terms of just dollars, but in a ratio that incorporates both health outcomesand dollars. Since healthier employees are more productive, improved outcomes actuallydo translate into dollars. But it is important to keep these values separate, so a decision

maker can understand what kind of health benefit isreturned on the investment. For instance, threeinvestment choices could have cost-effectiveness ratios of$10,000/premature birth avoided, $20,000/workplaceinjury prevented, or $30,000/life year gained. Thedecision maker must then choose the health interventionthat is right in terms of budget and population healthgoals.

CEAs compare several program strategies and then rank them by of cost-effectivenessratios. An analysis of two screening interventions might show you that one costs$10,000/life year gained while the other costs $40,000/life year gained. The firstintervention requires monthly screening and the second requires biannual screening.Realizing that compliance is a greater problem with monthly screening, the decisionmaker would have to implement the most appropriate coverage strategy for the populationin question. Sometimes, the analysis compares to baseline options such as “do nothing” or“usual care.” Both are valid strategic options.

Why Employers Use CEA

Cost-effectiveness analysis:

✓ Supports objective decision making: Decision makers can consider options in acomparable and objective way that provides support for the final decision.

✓ Brings clarity to data sources and outcomes: CEA evaluates options in similar terms toavoid “comparing apples to oranges.”

Cost-Effectiveness Ratio =

(All benefits)

(All costs)


✓ Allows for strategic review of organizations: CEA might justify some operationalcenters operating at a loss to increase overall return on investment, employee health,or both.

✓ Can be used in a host of operational and benefits areas including:• Screening coverage• Pharmacy• Strategic Planning• Labor Relations• Disease Management• Disability Management• Wellness and Prevention Programs

✓ Presents evidence that can help gain support for changes in benefits plans oremployer-sponsored health programs.

Common Applications

Evaluating Program OptionsIn the case of health screening, it is often difficult to determine the most cost-effectivefrequency. Too frequent screening has high cost and possibly limited health benefits, whiletoo infrequent screening has low cost, but poor health outcomes. Determiningappropriate screening frequencies is a useful application of cost-effectiveness analysis. Thefollowing table taken from an analysis on cervical cancer screening shows that life yearsare saved at a relatively low cost in the first comparison (screening versus no screening),but at a very high cost in the second comparison (the marginal cost and benefit ofdecreasing the interval between screenings). Typically, an intervention that costs less than$30,000/life year gained is considered cost-effective medicine. Based on this analysis,cervical cancer screening every four years is a relatively cost-effective benefit to cover. It iscertainly more cost-effective than screening every three years.


Table 1: Example Data from an Analysis of CervicalCancer Screening Frequency

S o u r c e : E d dy D.M. “Screening for Cervical Cancer,” Annals of Internal Medicine 1990; 113: 2 1 4 - 2 2 6 .

* Annual discount rat e adjust future costs and benefits to account for time preference and opportunity cost.

Justifying Program ImplementationWhen building a case to justify the use of funds, strong data is often compelling evidence.Cost-effectiveness analyses can be used to support qualitative arguments for healthinterventions. The following table examines a depression treatment improvementprogram. Treatment facilities in the study were offered training for practice leaders andnurses, enhanced educational and assessment resources, and trained psychotherapists forpatient follow-ups. Not only was the intervention relatively cost-effective, but it alsoincreased attendance in workers suffering from depression.

Table 2: Example Data from an Analysis of a DepressionTreatment Improvement Program

S o u r c e : Schoenbaum M. et al. “The Cost-effectiveness of Practice-Initiated Quality Improvement for Depression:Results from a Randomized, Controlled Tr i a l ,” JAMA 2001; 286: 1 3 2 5 - 1 3 3 0 .

Screen every threeyears vs. screen every

four years

1 . 60 . 2$ 9 1

$ 1 8 4 , 5 2 8

Screen every four yearsvs. no screening

9 3 . 89 . 5

$ 2 6 4$ 1 0 , 1 0 1

Quality improvementprogram vs. usual

care

0 . 0 2 2 6$ 4 8 5

$ 2 1 , 4 6 02 0 . 9

Life expectancy increase, d a y sLife expectancy increase, days (discounted 5%)*Cost increase, dollars (discounted 5%)Cost per life year gained

Quality-adjusted life year increaseCost increaseCost per quality adjusted life yearDays of employment increase


Cost-effectiveness analysis can be a valuable source of information and data for employers.Most employers are not in the business of conducting analyses; however, it is reasonable toexpect carriers to rationalize and explain different coverage options in terms of cost-effectiveness.

Strategic Implications

A System ViewBecause cost-effectiveness analysis examines a comprehensive set of costs and outcomes, itis important to avoid narrow strategy that only considers implication for individualdepartment programs or cost centers. Managers can examine all parts of the healthbenefits system to determine if financial losses in one area are recouped in another. Forexample, dollars spent in richer benefit reimbursement might increase utilization andavoid future costs of treatment.

The diagram below presents a system view of employer-sponsored health care.

S o u r c e : Michael T h o m p s o n , P r i c e w at e r h o u s e C o o p e r s

H e a l t hB e h a v i o r

S y m p t o m s& Disease

Diagnosis &Tr e a t m e n t

B e n e f i tR e i m b u r s e m e n t

I N P U T S• Diverse Wo r k f o r c e• Work Environment• HR & Benefits• Vendors & Providers

O U T P U T S• Health Stat u s• Productivity• Health Care Costs• Retention• Disability/Absenteeism• Presenteeism


Employers can use cost-effectiveness analysis to review each system component andchoose the best strategy to optimize utilization, improve outcomes, and encouragehealthier and more beneficial lifestyle choices.

Strategic ReadinessUnconventional methods like cost-effectiveness analysis are not an ideal fit for allorganizations. Every company that provides health benefits has a different strategy forplan design and analysis. In some organizations, an attempt to incorporate cost-effectiveness analysis into decision making might be resisted or rejected altogether. Toavoid such a misstep, assessment of corporate culture is necessary.

The diagram below shows health care strategy as a continuum. Organizations that aremore access-oriented analyze specific health care costs and delegate cost reductionresponsibility to their carriers. Goals focus on controlling costs so that employers cancontinue to offer health care access through employee benefits. Organizations that aremore system-oriented involve employees, employers, and health plans in dialogue aboutwhole health management. Shared goals focus on increasing health and changingutilization patterns to control future costs.

S o u r c e : Michael T h o m p s o n , P r i c e w at e r h o u s e C o o p e r s

A c c e s sO r i e n t e d

A p p r o a c h

Aware &I n a c t i v e

E m p l oy e eB e n e f i t

Health CareAccess & Cost

D e l e g at e dA c c o u n t a b i l i t y

S y s t e mO r i e n t e dA p p r o a c h

E n g age &E n a b l e

S h a r eR e s p o n s i b i l i t y

Health &Pe r f o r m a n c e

I n t e g r ated & O p t i m i z e d

Health Care Strategy

L e a d e r s h i p

C u l t u r e

F o c u s

Health Plans


To assess where large employers believe they lie on this continuum, a number of benefits,health, and human resources professionals rated their organizations on a scale from 1(mostly access-oriented) to 5 (mostly system-oriented) for the four component areas aswell as overall approach.


Practical Examples

Pharmaceutical FormulariesEmployers can use CEA to compare specific drugs on their formularies or evaluate thecost-effectiveness of their entire pharmaceutical benefits packages. In comparing specificdrugs, such as high-cost statins and beta-blockers, benefits managers address not only costdifferences between brand name and generic, but disparities in effectiveness as well. Thismight include examining effectiveness per dose cost. For example, a particular statin maybe the least expensive option per dose, but comparing it to other options in terms of costand ability to reduce LDL levels may prove it is a less cost-effective choice (see Table 3).

In analyzing an entire pharmacy program, employers determine costs for particular drugsin terms of tiers and responsibility. The recent trend has been for employers to shift moreof the costs of medications to employees through higher co-pays or co-insurance, but thismay not always be the most cost-effective long-term solution. Abandoning this strategymay create a financial loss on some prescriptions, but overall cost savings could besubstantial if absenteeism, presenteeism, and disability are reduced in the process.Companies might also consider how they will price brand name drugs versus generics,especially for medications that have proven to be similar in safety and effectiveness.

Table 3: Example Data from a Comparison of Six Statins

S o u r c e : Michael Jacobs, Mercer Human Resource Consulting

If decision makers were only looking for the lowest cost alternatives, they might select10mg of statin C. However, 40mg of statin E is the most cost-effective option. Thisdosage has the highest LDL reduction for the cost associated with it. Benefit managerscan consider this information in making formulary decisions; however, this may not bethe most favorable option when factors such as employee health characteristics, unions,and other issues weigh into the choice.

Daily Dose (% LDL reduction/dose cost)

S t a t i n 5 mg 10 mg 20 mg 40 mg 80 mgStatin A N / A 3 9 % / $ 2 . 0 4 4 3 % / $ 3 . 0 7 5 0 % / $ 3 . 0 7 6 0 % / $ 3 . 0 7Statin B N / A N / A 2 2 % / $ 1 . 5 6 2 5 % / $ 1 . 5 6 3 5 % / $ 1 . 9 7Statin C N / A 2 1 % / $ 0 . 9 6 2 7 % / $ 1 . 1 1 3 1 % / $ 1 . 9 7 N / AStatin D N / A 2 2 % / $ 2 . 5 0 3 2 % / $ 2 . 5 2 3 4 % / $ 3 . 0 7 3 7 % / $ 3 . 7 6Statin E 4 5 % / $ 2 . 2 2 5 2 % / $ 2 . 2 2 5 5 % / $ 2 . 2 2 6 3 % / $ 2 . 2 2 N / AStatin F 2 6 % / $ 1 . 6 3 3 0 % / $ 2 . 1 8 3 0 % / $ 2 . 1 8 4 1 % / $ 3 . 7 2 4 7 % / $ 3 . 7 3

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Disease Management and TreatmentCost-effectiveness analysis is a useful tool in developing and evaluating diseasemanagement and treatment programs. It allows employers to determine objectively whatservices to cover, for which populations, and how often. Employers, providers, andinsurers will normally seek the dominant choice — that choice which has lower costs andbetter outcomes than other choices in the same situation. Often, lower costs may berealized at the expense of outcomes, or better outcomes achieved at unacceptable costs. Insuch cases, cost-effectiveness analysis can compare options and lead to smarter choices.Employers and health plans can also use CEA to determine limits on coverage — forwhat age, for which populations, how often, and other restrictions. A helpful reference forsuch decisions may be the United States Preventive Services Task Force recommendationsfor clinical services. The Task Force critically examines published research, including cost-effectiveness analyses, to determine the practical feasibility of health interventionsrecommended in the literature.

Strategic Tips for Interpreting a CEA

✓ Consider perspective. Which parties are incurring costs and which parties arereceiving benefits? Many studies take a broad societal perspective; they are usually notwritten for an employer audience.

✓ Identify the strategies under comparison. Does the study compare differentalternatives (treat using drug A vs. treat using drug B) or examine incrementalchanges in the same health intervention (screen every two years vs. screen every fouryears)?

✓ Be aware of the analytic horizon. When are costs incurred and when are benefitsreceived? Most studies use a 3-5% annual discount rate to adjust both costs andbenefits to a present value, but if a benefit is not received until 10 years after anintervention begins, this is important information to note.

✓ Analyze all stated assumptions. Are the assumptions built into the economic modelclearly defined, and are they valid for employers?

✓ Examine the sensitivity analysis. How do differences in data inputs affect theoutcome? Think how this relates to the health characteristics of your employeepopulation.

✓ Understand all metrics. How did the author present the cost-effectiveness ratio?Most studies measure the costs of increased quality of life ($/quality adjusted life yeargained), disability prevented ($/disability adjusted life year prevented) or of life saved($/life year gained). A study that measures quality adjusted life years is called a cost-utility analysis, a specific type of CEA.

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Sample Abstract

The following abstract from a study published in the Journal of the American MedicalAssociation shows that nicotine patch therapy, in conjunction with physician counseling,is a cost-effective approach to smoking cessation. This is an example of information inpublished CEAs that can support coverage decisions and justify health improvementprograms.

Cost-effectiveness of the transdermal nicotine patch as an adjunct to physicians' smokingcessation counseling

K. Fiscella and P. Franks Primary Care Institute, Highland Hospital, Rochester, NY, USA.

OBJECTIVE: To determine the incremental cost-effectiveness of the transdermal nicotinepatch. DESIGN: Decision analytic model that evaluated the incremental cost-effectivenessof the addition of the nicotine patch to smoking cessation counseling. Costs were basedon physician time and the retail cost of the nicotine patch, and benefits were based onquality-adjusted life years (QALYs) saved. PATIENTS: Male and female smokers aged 25to 69 years receiving primary care. INTERVENTION: Addition of the nicotine patch tophysician-based smoking cessation counseling. MAIN OUTCOME MEASURE: Costs(1995 dollars) per QALYs saved discounted by 3% annually. RESULTS: The use of thepatch produced one additional lifetime quitter at a cost of $7,332. The incremental costeffectiveness of the nicotine patch by age group ranged from $4,390 to $10,943 perQALY for men and $4,955 to $6,983 per QALY for women. A clinical strategy involvinglimiting prescription renewals to patients successfully abstaining for the first two weeksimproved the cost-effectiveness of the patch by 25%. CONCLUSIONS: The findingsprovide support both for the routine use of the nicotine patch as an adjunct to physicians’smoking cessation counseling and for health insurance coverage of nicotine patch therapy.

From JAMA 1996; 275: 1247-1251.


Case Studies

Case Study 1 — A Large Manufacturing Company Redefines Pharmacy Benefits

This global manufacturer of document management systems operates in more than 130countries with more than 35,000 employees worldwide and 27,000 employees in theUnited States. The company’s services include document management and mail securityproducts and systems.

In 2001, this company took a bold step to stem the rising costs of its health care benefits.In analyzing where costs were the highest, the company found that those employees withchronic conditions such as diabetes and asthma incurred the highest cost. Startlingly, theyfound that many of these individuals did not refill their prescriptions properly because ofthe high co-insurance price. Using predictive modeling to come to this conclusion andhoping that increasing compliance would lower costs, the company’s medical directorrestructured its pricing tiers for pharmaceuticals. The organization implemented a newmulti-tiered system in which generics and those drugs targeting chronic conditions suchas diabetes and asthma (including prescriptions for inhalers and insulin) would require co-pays as low as 10% of the total cost.

After implementing this new pricing system at the end of 2001, the company realizedsignificant cost savings. Lower co-payments for the two chronic conditions had increasedcompliance. Cost savings also came from fewer emergency room visits and hospitaladmissions due to better personal disease management. Median medical costs for eachemployee with diabetes fell 12%, and the company saved $1,000 per employee. For thosewith asthma, median medical costs dropped 15% with a savings of $900 per person. Thecompany predicts savings estimated at $1 million in 2004 and even more in future years.By using data-driven, total health strategy, a change that seemed costly has proven to becost-effective.


Case Study 2 — A Large Airline Reexamines Health Benefits Strategy

This airline has more than 3,000 daily departures, flies to 38 states including the Districtof Columbia and 41 sites internationally, and employs more than 28,000 individuals. Theorganization recently faced several challenges:

• Negotiating with nine unions twice• Filing for bankruptcy• Outsourcing health care administration, which had been done internally• Consolidating 23 health plans down to a single one

During this period, many employees expressed discontent about plan changes, coveragedecisions, and health care access. New executive leaders decided to fundamentally changehealth benefit strategy, including the use of cost-effectiveness analysis in plan designdecisions. The company took the following actions:

• Requesting reports from vendors to assess health plan information• Forming a collaborative union management group• Establishing an internal plan performance group, including both finance and labor

relations staff, to review health care data sets

The airline is currently pursuing strategy that will facilitate positive health plan changes,made in collaboration with its unions and its health insurance carrier. Although it stillfaces serious financial challenges, the airline is now examining its health plan throughdata-driven discussions on whole health management and including cost-effectivenessanalyses in health benefit strategy.


Conclusion

Cost-effectiveness analyses provide quantitative support to managerial decision-making.Budget requests and in-house proposals for health program change can be moreconvincing with the addition of cost-effectiveness data. Asking vendors and consultants tosupport their products and proposals with cost-effectiveness data assures managers theyare purchasing based on value. Organizations use these approaches and others becausethey recognize that objective economic analyses such as CEA are sound corporate strategy.


Glossary of Cost-effectiveness Terms

Many definitions are from Prevention Effectiveness: A Guide to Decision Analysis andEconomic Evaluation. See references for more information.

✓ Agency for Healthcare Research and Quality (AHRQ): A federal agency with the mission to improve the quality, safety, efficiency, and effectiveness of health care for allAmericans.

✓ Analytic horizon: The time period over which the costs and benefits of health outcomes that occur as the result of an intervention are considered.

✓ Annual discount rate: Adjustment made to the value of future costs and benefits to account for time preference and opportunity cost.

✓ Approach, access-oriented: Providing employees access to the health system through their benefits packages and managing costs by analyzing data for each covered benefit.

✓ Approach, system-oriented: Promoting employee health through an interrelated system of programs and benefits and managing costs with the knowledge that investment in one program or benefit may be offset by savings in others.

✓ Cost-effectiveness: The minimum cost for a given benefit, the maximum benefit for agiven cost, or a balance of low costs and high benefits that has maximum utility.

✓ Cost-effectiveness analysis (CEA): An economic analysis in which all costs arerelated to a single, common effect, usually in terms of cost expended per outcome achieved.

✓ Cost-effectiveness ratio: The ratio of total costs of investment to total accrued benefits, in terms of both dollars and benefit value.

✓ Cost-utility analysis (CUA): A type of cost-effectiveness analysis in which benefits are expressed in terms of cost per QALY gained.

✓ Dominant choice: Choice with both lower costs and higher benefits than all other options.


✓ Life year gained: An outcome measure that incorporates only duration of survival, not quality of life.

✓ Quality adjusted life year (QALY): A frequently used outcome measure that incorporates the quality and desirability of a health state with the duration of survival;quality of life is integrated with length of life using a multiplicative formula.

✓ Return on investment (ROI): The ratio of capital investment in dollars to accrued return in dollars.

✓ Sensitivity analysis: Mathematical calculations that isolate factors involved in an analysis to indicate the degree of influence each factor has on the outcome of the analysis.

✓ Societal perspective: Analytic view that includes all benefits of a program regardless of who receives them and all costs regardless of who pays them.


Web Resources

✓ Agency for Healthcare Research and Qualityhttp://www.ahrq.gov/research/costeff.htm

AHRQ is a leader in advancing the science of cost-effectiveness analysis in health care.This page explains current initiatives in this discipline, including the Research Initiative in Clinical Economics.

✓ United States Preventive Services Task Forcehttp://www.ahrq.gov/clinic/uspstfix.htm

USPSTF is an independent panel of experts in primary care and prevention that systematically reviews the evidence of and develops recommendations for clinical preventive services.

✓ National Health Service Centre for Reviews and Disseminationhttp://www.york.ac.uk/inst/crd/crddatabases.htm

The United Kingdom’s National Health Service maintains databases of economic evaluations and health technology assessments at the University of York.

✓ Harvard Center for Risk Analysis CEA Registryhttp://www.hsph.harvard.edu/cearegistry/

The Harvard School of Public Health maintained a reference list of cost-effectiveness analyses from 1976-2001. It does not include more current studies, but serves as a useful historical database.


Print Resources

✓ Haddix A., Teutsch S., Corso P. Prevention Effectiveness: A Guide to Decision Analysis and Economic Evaluation. New York: Oxford University Press, 2003.

Officials from AHRQ and CDC collaborated with leading academics on this text. Itgives in-depth explanations of cost-effectiveness analysis beginning with theory and concluding with application.

✓ Gold M. R., Siegel J. E., Russell L. B., Weinstein M.C. Cost-Effectiveness in Health and Medicine. New York: Oxford University Press, 1996.

This report details the recommendations of the Panel on Cost-Effectiveness in Health in Medicine, a committee of researchers convened by the United States Public Health Service to establish guidelines for analyses. The findings of the Panel are also outlined in three articles in the Journal of the American Medical Association (JAMA 1996; 276: 1172-1177, 1253-1258, and 1339-1341).

✓ Schoenbaum M., Unutzer J., Sherbourne C., Duan N., Rubenstein L.V., Miranda J., Meredith L.S., Carney M.F. and Wells K. “The Cost-effectiveness of Practice-InitiatedQuality Improvement for Depression: Results from a Randomized, Controlled Trial,” JAMA 2001; 286: 1325-1330.

Dr. Schoenbaum, a speaker at the May 2004 web event, conducted an analysis of a quality improvement program for depression treatment (see Page 3, Table 2 ). His publication demonstrates the usefulness of cost-effectiveness analysis as an evaluativetool.

✓ Neumann P.J. “Why Don’t Americans Use Cost-Effectiveness Analysis?” American Journal of Managed Care 2004; 10: 308-312.

Neumann presents a short editorial explaining resistance to cost-effectiveness analysis in the United States. He surmises the positions of different stakeholder groups towardCEA and offers thoughts to help decision makers better use CEA in the future.


References

✓ Fuhrmans V. “A Radical Prescription.” Wall Street Journal, May 10, 2004.

✓ Haddix A. et al. “Prevention Effectiveness: A Guide to Decision Analysis and Economic Evaluation.” New York, NY: Oxford University Press, 2003.

✓ Fiscella K. and Franks P. “Cost-effectiveness of the transdermal nicotine patch as an adjunct to physicians’ smoking cessation counseling.” JAMA 1996; 275: 1247-1251.

ISSUEBriefAugust 2004

Cost-Effectiveness Analysis:An Employer Decision Support Tool

Center forPrevention and Health

S e rv i c e s

Written by:

Ian Dixon and Andrew Lundeen, National Business Group on Health

About the Center for Prevention and Health Services (CPHS)

The Center houses the Business Gro u p’s projects and re s o u rces that relate to the delive ry of pre ve n t i ve and other health services through employe r - s p o n s o red health plans and work s i t ep rograms. T h rough the Center, employers can find practical toolkits to address pre ve n t i ve health and health promotion issues at the worksite. Em p l oyers will find current information and recommendations from federal agencies and professional associations, model programs f rom other employers, and the latest clinical and health services re s e a rch results. In addition, the Center provides opportunities for employer participation in teleconferences and in-personsolutions workshops. Cu r re n t l y, the Center has initiatives in racial and ethnic disparities in healthand health care, terrorism and public health emergency pre p a redness, maternal and child health,p re ve n t i ve services, health services re s e a rch and quality, health and work performance, benefitdesign, and wellness pro g r a m s .

For more information, visit http://www. b u s i n e s s g ro u p h e a l t h . o r g / p re vention/index.cfm or contact Ron Finch, EdD, Di re c t o r, at finch@businessgro u p h e a l t h . o r g .

About the National Business Group on Health

The National Business Group on Health, formerly the Washington Business Group on He a l t h ,is the national voice of large employers dedicated to finding innova t i ve and forw a rd - t h i n k i n gsolutions to the nation’s most important health care issues. The Business Group re p resents ove r200 members, primarily Fo rtune 500 companies and large public sector employers, who prov i d ehealth coverage for approximately 50 million U.S. workers, re t i rees, and their families. T h eBusiness Group fosters the development of a quality health care delive ry system and tre a t m e n t sbased on scientific evidence of effectiveness. The Business Group works with other organizationsto promote patient safety and expand the use of technology assessment to ensure access to superior new technology and the elimination of ineffective technology.

Helen Darling, Pre s i d e n t

National Business Group on He a l t h50 F St reet NW, Suite 600 • Washington DC 20001Phone (202) 628-9320 • Fax (202) 628-9244 • www. b u s i n e s s g ro u p h e a l t h . o r g

Cost Effectiveness Analysis in Health economics

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