Documenting Outcomes, Benefits, & Costs
When developing the business case, the measure developer should evaluate and report on all potential positive and negative impacts resulting from a measure, such as clinical or cost outcomes. See the Business Case Form & Instructions.
Clinical Outcome Examples
- Preservation of healthy lifestyles for individuals receiving care
- Lives saved
- Complications prevented
- Clinical practice improved
- Enhanced experience for those receiving care
Cost Outcome Example
An example of a positive cost outcome resulting from a measure may include reduced expenditures for payors, measured entities, or individuals, which may occur indirectly, e.g., as when increased spending on preventive care reduces spending on subsequent health care needs.
Considerations for Costs, Benefits, & Savings
In making the business case, the measure developer should qualify and quantify the advantages and disadvantages of implementing the measure, including hard and soft benefits. For example, a measure intended to reduce long-term mortality through early detection and treatment may cause increased short-term costs and potential complications from screening tests.
Patient Considerations |
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Employee and Organizational Considerations |
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Liability Considerations |
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Material Considerations |
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Quality Improvements
By documenting the potential improvement anticipated from implementing a specific measure, the measure developer can make a strong case for why the organization should invest resources in development (or continued use) of the specific measure in its quality initiatives. At a minimum, the business case for a measure should state explicitly, in economic and societal terms, the expected costs and benefits of the measure.
Examples of Quality Improvement Benefits
- Better care through reduction of harm and positive influence on patients’ perception of their care
- Better health through reduction in mortality and morbidity and improvements in quality of life
- More affordable care through cost savings