ACA'S IMPACT ON MERGERS AND WELLNESS- ASSESSING VALUE FOR MONEY
Author(s)
Vu M1, Lovett AW1, Kelley VP2, Hopper J2, Liu C1
1Mercer University, Atlanta, GA, USA, 2Piedmont Healthcare, Atlanta, GA, USA
Presentation Documents
OBJECTIVES: The Affordable Care Act (ACA) initiated healthcare reforms that stress “triple aim” goals: improving patient care, population health, and reducing costs. Hospitals are forming mergers and have expanded their employee health and wellness programs. The objectives are to (1) summarize the literature on mergers, health outcomes, and cost-containment (2) describe value for money of health and wellness programs, and (3) provide examples of successful mergers. METHODS: A systematic review was conducted to identify the costs and benefits of mergers and wellness programs. Articles after 2008 were compiled using search engines PubMed, Galileo, Ebscohost, and Google Scholar. Key terms were “value for money”, “corporate”, “health and wellness program”, “health plan”, “insurance plan”, “hospital”, and “merger.” Exclusion criteria were articles involving forms of consolidation and wellness programs not tied to insurance plans and without reported costs and/or health outcomes. RESULTS: A total of 29 relevant articles were retrieved. Findings revealed mergers prevent hospitals from trading-off quality and services for cost reductions. However, studies suggest that anticompetitive effects of mergers will increase costs. Before the ACA, employers had wellness programs that were not standardized. The ACA encouraged improvement of these programs by funding expanded services and mandating quality. Studies show that wellness programs are growing in number and in various sizes, services, and incentives resulting in a significant to non-significant return-on-investment (ROI). Few employers have measured the ROI and even fewer their health outcomes. However, successful programs have shown a median ROI between 2:1 and 3:1. Studies suggest that disease-management services account for significantly positive ROI while lifestyle management services do not. For example, the partnership between Piedmont and WellStar of Georgia supported implementation of care-management programs, with higher quality at lower costs. CONCLUSIONS: Although most are not reporting ROI, studies show the value of wellness programs should be based on health outcomes.
Conference/Value in Health Info
2015-05, ISPOR 2015, Philadelphia, PA, USA
Value in Health, Vol. 18, No. 3 (May 2015)
Code
PHP81
Topic
Economic Evaluation, Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Health Care Research, Risk-sharing Approaches
Disease
Multiple Diseases