About the Study
In 2022, the Chief Evaluation Office (CEO) partnered with the Employee Benefits Security Administration (EBSA) to fund contractor Manhattan Strategy Group and subcontractor American Institutes of Research to conduct the EBSA Health Outcomes Metrics Study. The study aims to better understand the current landscape, best practices, and data sources related to approaches that federal and state agencies and the insurance industry use to estimate the impacts of their health-related enforcement actions and interventions.
This Department of Labor-funded study was a result of the learning agenda process. It contributes to the labor evidence-base to inform worker protection, labor standards, and workplace-related benefits programs and policies and addresses Departmental strategic goals and priorities.
- EBSA Health Outcomes Metrics: Literature Scan (Literature Review, August 2024)
- What metrics—monetary and non-monetary—are being used by academics, the insurance industry, and by other regulatory agencies to estimate the impact of changes to health benefits coverage?
- What data sources and analytical methods are used to develop these metrics?
- What specific metrics could EBSA use to measure the impact of its enforcement work?
The study team identified outcomes common throughout the studies and organized them, based on the content/focus, into four outcome categories: claims system/benefits management, service utilization, insurance coverage, and macro-level/long-term outcomes. The metrics most relevant to measuring the impact of EBSA’s work were found within the three following categories described further below.
- Claims system/benefits management metrics such as Plan design changes to meet regulatory coverage requirements as well as those related to Enforcement actions are relevant as they examine the most immediate results of EBSA’s work.
- Service utilization metrics, including rates of Inpatient/outpatient visits and Access to and quality of care, stand out due to their prevalence in the literature. They also relate to the kinds of changes EBSA’s interventions can create, such as improving plan members’ access to given benefits, and, therefore, utilization.
- Insurance coverage metrics, which primarily focus on capturing changes in Spending/expenditures (medication cost changes, total/average out of pocket-spending/max, etc.), are worth further exploration because they relate directly to some of the changes that EBSA’s interventions can create in plans and benefit design.
Cadima, J., Corea, C., Perlman, E. (2024). American Institutes for Research. EBSA Health Outcomes Metrics Literature Scan. Chief Evaluation Office, U.S. Department of Labor.
Contractor: Manhattan Strategy Group, American Institutes for Research
Project Duration: 2 years
Project End Date: February 2024
For More Information: ChiefEvaluationOffice@dol.gov
The Department of Labor’s (DOL) Chief Evaluation Office (CEO) sponsors independent evaluations and research, primarily conducted by external, third-party contractors in accordance with the Department of Labor Evaluation Policy. CEO’s research development process includes extensive technical review at the design, data collection and analysis stage, including: external contractor review and OMB review and approval of data collection methods and instruments per the Paperwork Reduction Act (PRA), Institutional Review Board (IRB) review to ensure studies adhere to the highest ethical standards, review by academic peers (e.g., Technical Working Groups), and inputs from relevant DOL agency and program officials and CEO technical staff. Final reports undergo an additional independent expert technical review and a review for Section 508 compliance prior to publication. The resulting reports represent findings from this independent research and do not represent DOL positions or policies.