Maricopa Integrated Health System: Social Return on Investment, 2013 October 29, 2014

Introduction Seidman = consultancy arm of W. P. Carey School of Business, ASU Commissioned by MIHS to implement 3 analyses: – Economic Impact of MIHS in 2013 – Economic Impact of MIHS, 2015 – 2043 – Social ROI analysis Today’s presentation focuses on the Social ROI analysis

Partial Net Analysis: Annual Statewide Results Total Private Non-Farm Employment CY ,327 8,527 to 11,718 Job Years CY Ratio of 1 MIHS job:1.13 PNFE jobs CY Ratio of 1 MIHS job:1.4 PNFE jobs Gross State Product Real Disposable Personal Income State Tax Revenue Total Private Non-Farm Employment CY2013 $834 M. $456 M. $37 M. $1.3 B. $844 M. $86 M.

Seidman’s Method Economic Cost of Ill Health = Medical Cost Cost of Presenteeism Cost of Absenteeism + + Cost of diagnosis, management and treatment Economic cost of lost work days due to illness Economic cost of underperforming workers due to illness

Economic Metrics: State of Arizona Condition Medical Treatment Costs Per Patient (2013 $) Absenteeism Annual $ Impact Per Patient (2013 $) Presenteeism Average Annual $ Impact Per Patient (2013 $) Allergy9792,1605, ,101 Arthritis1,3991,5463, ,101 Asthma1,9543,1544, ,101 Cancer4,6954,4491, ,523 Diabetes3, , ,101 Heart Disease17,4521,7853,945 Hypertension1, ,734 Mental Disorder2,2966,7325, ,467 Migraine1,2612,8235, ,623 Respiratory Disorders21,7613,8727, ,045 Average – All 10 Diseases5,7202,7283, ,574 Sources: Milken Institute; MEDSTAT Group

MIHS 2013 Unique Out-Patient Data ConditionCHCFHC OP Aftercare/Follow Up3, OP All Other131 OP Behavioral Health OP Benign Neoplasms1, OP Burns805 OP Cancer2,33287 OP Cardiovascular3,0561,435 OP Dermatology3, OP Digestive3, OP Endocrine5,7182,218 OP ENT1, OP General Medicine7,9081,478 OP Gynecology2, ConditionCHCFHC OP Infectious Disease2, OP Neonates2963 OP Nephroplogy57388 OP Neurosciences5,4221,029 OP Newborn3228 OP Obstetrics4,35777 OP Opthamology6, OP Orthopedics6, OP Pulmonary3, OP Rheumatology1, OP Screenings/Exam8,7152,596 OP Urology2, Total79,70914,235 Source: MIHS

MIHS Economic Benefit Estimates, % Success Rate 50% Success Rate = = $ $360.7 Million $ $721.4 Million

Caveats and Conclusions Previous estimates are conservative – Use 25% and 50% successful intervention rates Based on MIHS’ 2013 CHC and FHC out-patients In SROI alone, MIHS could justify the total repayment of the Bond in approximately 2-5 years MIHS facility improvements, and potential for greater patient intervention success, post-Bond could increase the SROI

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