Ask the Consultants

Is there a disease management industry standard for an average or expected ROI, and an average time in which it should be achieved? When calculating ROI, do you include soft savings such as patient satisfaction or potential savings?

(Michael Montijo, MD, MPH, FACP, senior vice president of government relations, American Healthways) First of all, there isn’t a standard. An average ROI depends upon many factors. Secondly, there are different ROIs depending upon the condition or disease or groups of conditions and diseases that are being targeted. It also depends upon the type of program---whether it’s an engagement versus an enrollment program.

In regard to average time to achieve ROI, this relates to the critical mass. You reach critical mass when you are touching enough of the population to render significant change. Normally, the change measured in this instance is improvement in the overall cost profile of the population. The faster you reach critical mass, meaning the more people you touch earlier on, the sooner you begin to accrue savings and an ROI. All programs, if they have any credence, will be able to provide an ROI in the first year.

Regarding soft savings such as patient satisfaction or potential savings as part of ROI, most people in the industry do not attach those, since it’s difficult to put dollars to them. People are beginning to attach things such as absenteeism and disability types of savings. This is still in the embryonic stage because this data is hard to come by.

The final arbiter of a program’s success probably should not be ROI. Not that one should not look at that, but it is only one metric. Other metrics such as the value added back to the population is more significant. It’s easy to get an ROI even touching a small population. But you’ll probably not get a lot in terms of total value for your money.