The role of outcomes research in defining and measuring value in benefit decisions

OBJECTIVE: To identify ways that health care leaders at all levels can quantify the value proposition, thus influencing health care delivery and improving patient care. SUMMARY: Payers and providers need to support, with rigorous research, the value proposition for customers. Outcomes research focusing on clinical and cost-effectiveness analysis can provide an understanding of successful, replicable interventions. Randomized controlled trials and observational studies can be used to reinforce and refine the business proposition in health care, and they can be integrated to target populations needing health care services. Evaluations using clinical and outcomes research can also predict what is likely to be successful in the future. To maximize the business value of projects, they must incorporate a prospective evaluation component that includes asking the right research questions, identifying an appropriate time period, including a targeted population, articulating a replicable intervention, and determining the correct statistical analysis. CONCLUSION: Well-designed studies to analyze specific patient populations and their patterns of care can be used to determine a generalizable model to refine successful interventions that meet the critical value proposition for employers.