Measuring the Impact of Community Health
A groundbreaking study led by OMG’s Director of Research, Jill Gurvey, provides statistical evidence that critically ill and nutritionally at-risk people served by MANNA (Metropolitan Area Neighborhood Nutrition Alliance) incur lower health care costs than similar people who do not receive this service. In an interview, Jill describes her research for MANNA, ties that study to other OMG engagements in community health, and explains the value of using rigorous data to improve programs, secure funding, and guide expansion.
MANNA asked you to study how their program impacts health care costs. What does MANNA do and why is the study groundbreaking?
MANNA promotes wellness in Eastern Pennsylvania and Southern New Jersey by preparing and home-delivering meals to individuals with HIV/AIDS, cancer, or other life-threatening illnesses who are home bound and at-risk nutritionally. In addition to meals, MANNA provides their clients with compassionate human contact from caring community volunteers and teaches their clients to make intelligent nutrition choices.
MANNA asked OMG to develop a research study to see if their program saved the health care system money. A comprehensive program like theirs has never before been studied, which is why the research is groundbreaking. Our findings verified MANNA’s assumptions about cost savings and now, for the first time, the organization can show funders and policymakers solid evidence about their program’s positive financial impact on the health care system.
How did you design the study?
MANNA wanted to understand whether or not their program saved health care dollars. To get at that question, we needed to analyze cost and utilization data not only of MANNA clients before and after program participation, but also examine costs and utilization of a similar group of individuals who were not receiving MANNA services during a similar timeframe. Our study design, which included both of these elements, depended heavily upon the willingness of a local managed care organization (MCO) to provide member information about people who receive MANNA services and a comparable group of members from the same MCO who was not receiving MANNA services. We also conducted individual interviews with a subset of clients to round out our findings.
What are your key findings?
Among MANNA clients, average monthly costs fell 62 percent in the first three months, and for clients with HIV/AIDS, average monthly costs fell by over 80 percent in the first three months. Clients who received MANNA services had significantly lower overall health care costs compared with those who did not receive MANNA services. On average, MANNA clients cost the MCO $12,000 less per month and spent six fewer days per month in the hospital than non-MANNA participants. When we looked just at the people in the study with HIV/AIDS, we found that MANNA clients with HIV/AIDS cost the MCO $20,000 less per month: $17,000 versus $37,000 per month.
The data speak to the power of the comprehensive service delivered by MANNA at a cost of only $450 per month per person. Clearly, broad replication of the program would benefit the healthcare system.
Your study for MANNA fits within OMG’s diverse portfolio of work in the community health field. Tell me a little about the portfolio.
OMG works with strategies that focus on access to healthy food, childhood obesity prevention, and quality healthcare. All the programs in our portfolio seek to better understand how to achieve healthy outcomes for people who are typically underserved. We support community health strategies with evaluations and research; strategy development; and thought leadership convenings.
Your own career has focused on statistical research and analysis. OMG has a distinguished history of qualitative research. What is the value of using quantitative and qualitative evidence in research?
As we try to understand what works in the field to either scale effective models and/or tweak them to be more effective, it is critical to provide clear evidence and to tell persuasive stories about impact. I don’t think quantitative results are more powerful than qualitative results, but I think that that’s often the perception. It’s important to see hard numbers, as hard numbers are often compelling. That said, qualitative data, if collected and reported on properly, are just as compelling. These kinds of data tell us about the human implications and nuances behind the numbers. Ideally, you have quantitative results to support strong and rigorous qualitative findings. The key is balance and weaving together the story so people can understand the impact in terms of real lives. OMG is strong in both methodologies and in knowing how to easily share the strategic implications for our clients and the people and communities they serve.