|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||($9)||Benefits minus costs||($496)|
|Participants||($134)||Benefit to cost ratio||($0.72)|
|Others||$59||Chance the program will produce|
|Indirect||($123)||benefits greater than the costs||27 %|
|Net program cost||($288)|
|Benefits minus cost||($496)|
|Meta-Analysis of Program Effects|
|Outcomes measured||Treatment age||No. of effect sizes||Treatment N||Adjusted effect sizes(ES) and standard errors(SE) used in the benefit - cost analysis||Unadjusted effect size (random effects model)|
|First time ES is estimated||Second time ES is estimated|
Blood pressure in the typical clinical range.
Blood sugar (HbA1c)^
Measure of average blood sugar over 10-12 weeks.
Total cholesterol (low-density lipoprotein and high-density lipoprotein).
Emergency department visits
Whether someone visited the emergency department, or the number of times they visited the emergency department.
Hospital admission, for any reason.
Obese based on clinical guidelines for adults (body mass index of 30 or higher) or children (body mass index at or above the 95th percentile for children of the same age and sex), as appropriate.
Primary care visits^
Visit to a primary care physician for any reason.
Smoking tobacco on a regular basis.
|Detailed Monetary Benefit Estimates Per Participant|
|Affected outcome:||Resulting benefits:1||Benefits accrue to:|
|Regular smoking||Labor market earnings associated with smoking||($59)||($139)||$0||$0||($198)|
|Health care associated with smoking||($17)||($5)||($17)||($8)||($47)|
|Mortality associated with smoking||$0||$0||$0||($4)||($5)|
|Hospitalization||Health care associated with general hospitalization||$43||$2||$42||$21||$108|
|Emergency department visits||Health care associated with emergency department visits||$23||$6||$34||$12||$75|
|Obesity||Labor market earnings associated with obesity||$1||$1||$0||$0||$2|
|Mortality associated with obesity||$0||$0||$0||$0||$0|
|Program cost||Adjustment for deadweight cost of program||$0||$0||$0||($144)||($144)|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$270||2014||Present value of net program costs (in 2018 dollars)||($288)|
|Comparison costs||$0||2014||Cost range (+ or -)||20 %|
Benefits Minus Costs
Benefits by Perspective
Taxpayer Benefits by Source of Value
|Benefits Minus Costs Over Time (Cumulative Discounted Dollars)|
|The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in discounted dollars. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.|
Friedmann, P.D., Hendrickson, J.C., Gerstein, D.R., Zhang, Z., & Stein, M.D. (2006). Do Mechanisms That Link Addiction Treatment Patients to Primary Care Influence Subsequent Utilization of Emergency and Hospital Care?. Medical Care, 44(1), 8-15.
Laine, C., Hauck, W.W., & Turner, B.J. (2005). Availability of Medical Care Services in Drug Treatment Clinics Associated with Lower Repeated Emergency Department Use. Medical Care, 43(10), 985-995.
Scharf, D.M, Eberhart, N.K., Horvitz-Lennon, M., R. Beckman, Han, B., Lovejoy, S., Pincus, H.A., Burnam, M.A. (2013). Evaluation of the SAMHSA Primary and Behavioral ehalth Care Integration Program: Final report. Rand Corporation. http://aspe.hhs.gov/daltcp/reports/2013/PBHCIfr.shtml
Umbricht-Schneiter, A., Ginn, D.H., Pabst, K.M., & Bigelow, G.E. (1994). Providing medical care to methadone clinic patients: referral vs on-site care. American Journal of Public Health, 84(2), 207-210.