Value Index

The purpose of a value index is to convert the results of the value equation to a standardized measure of value. For example the value index can be defined as the effect size per $1000 of cost, which was calculated as follows: effect size divided by the cost of care multiplied by $1000.

The value index should be calculated after adjusting for differences in caseload. See Case Mix Adjustment.

Providers differ in reimbursement rates depending on degree and licensure type. Since degree and licensure type tend not to be predictive of treatment outcome, providers with lower levels of compensation will tend to have higher Value Index scores. It is possible to adjust the value index to account for differences in reimbursement rates, so the Value Index gives an indication of value when compared to providers with similar reimbursement rates treating similar patients.

An alternative method to calculate a value index is to estimate the change per session, which obviates the need to adjust for different reimbursement rates.

The use of a Value Index score as a performance indicator encourages clinicians to strive for better than average outcomes, while using the outcomes measures to inform decision making regarding a rational allocation of resources. The use of questionnaires combined with the performance feedback provided by the outcomes management system provides the motivated clinician with powerful decision support tools to assist in increasing his or her Value Index score.

As a rule, clinicians with better than average outcomes tend to average slightly fewer sessions than clinicians with below average results. This appears to be due to the fact that the more effective clinicians tend to average more change per session and achieve results in a shorter period of time.

It is possible for a clinician to have a relatively high Value Index score while still having poor treatment outcomes if the clinician's length of treatment is very short, so that only improvement in the first few sessions is being measured. For this reason, the Value Index score should be combined with the use of outcomes benchmarking when identifying "high value providers". High value providers offer a greater return on investment to the health plan and employers for expenditures of behavioral health treatment services.

-- JebBrown - 17 Feb 2007

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Primary topics:

• Measure What? Why?
• Global Distress/Well-being Factor
• Absenteeism & Presenteeism
• Items or Questionnaires?
• Outcomes Measurement 2.0
• Reliability and Validity
• Measurement Error
• Measuring Change
• Regression to the Mean
• Clinical Cutoff Score
• Reliable Change Index
• Effect Size
• Meta-analysis
• Case Mix Adjustment
• Severity Adjusted Effect Size
• Outcomes Benchmarking
• Trajectory of Change
• Random Walk Hypothesis
• Rational Resource Allocation
• Therapist Effects
• Value Index

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