Benefit-Cost Results

Since the 1990s, the Washington State legislature has directed WSIPP to identify “evidence-based” policies. The goal is to provide Washington policymakers and budget writers with a list of well-researched public policies that can, with a high degree of certainty, lead to better statewide outcomes coupled with a more efficient use of taxpayer dollars.

Research Approach. WSIPP has developed a three-step process to draw conclusions about what works and what does not to achieve particular outcomes of legislative interest. First, we systematically assess all high-quality studies from the United States and elsewhere to identify policy options that have been tested and found to achieve improvements in outcomes. Second, we determine how much it would cost Washington taxpayers to produce the results found in Step 1, and calculate how much it would be worth to people in Washington State to achieve the improved outcome. That is, in dollars and cents terms, we compare the benefits and costs of each policy option. It is important to note that the benefit-cost estimates pertain specifically to Washington State; results will vary from state to state. Third, we assess the risk in the estimates to determine the odds that a particular policy option will at least break even. ...show more

WSIPP acknowledges the MacArthur Foundation and the Pew Charitable Trusts that have helped fund some of the research reported on this page.

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Overview of WSIPP's Benefit-Cost Model

Estimating Program Effects Using Effect Sizes

For details on our benefit-cost methods, contact Heather Grob or download our Technical Documentation.

Latest Results. The tables on this webpage present our current findings for a variety of public policy topics. Items on these tables are updated periodically as new information becomes available. Interested readers can find more information by clicking each entry in the tables.

Use the search fields below to find specific benefit-cost results that match certain criteria. If you want to find other information on our website that is not benefit-cost results, you can use the search field in the navigation bar at the top, or click here to search the entire website.

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Benefit-cost methods last updated December 2023

Current estimates replace old estimates. Numbers will change over time as a result of model inputs and monetization methods.

Health Care

For questions on benefit-cost results relating to Health Care, contact Eva Westley.

Obesity and Diabetes
Program name (click on the program name for more detail)	Date of last literature review	Total benefits	Taxpayer benefits	Non-taxpayer benefits	Costs	Benefits minus costs (net present value)	Benefit to cost ratio	Chance benefits will exceed costs
Lifestyle interventions to prevent diabetes: Long-term, intensive, individual counseling programs	Feb. 2017	$36,463	$10,598	$25,865	($4,456)	$32,007	$8.18	100%
Lifestyle interventions to prevent diabetes: Shorter-term programs with group-based counseling	Feb. 2017	$21,958	$6,198	$15,760	($525)	$21,433	$41.79	78%
Behavioral interventions to reduce obesity for adults: High-intensity, in-person programs	Dec. 2014	$2,458	$680	$1,778	($735)	$1,723	$3.34	61%
Behavioral interventions to reduce obesity for adults: Remotely-delivered programs	Dec. 2014	$852	$218	$634	($112)	$740	$7.61	55%
Behavioral interventions to reduce obesity for children: Remotely-delivered programs	Dec. 2014	$24	$15	$9	($76)	($52)	$0.32	49%
Behavioral interventions to reduce obesity for adults: Low-intensity, in-person programs	Dec. 2014	$154	$63	$91	($217)	($63)	$0.71	49%
Behavioral interventions to reduce obesity for children: Low-intensity, in-person programs	Dec. 2014	($38)	$14	($52)	($193)	($232)	($0.20)	46%
Behavioral interventions to reduce obesity for children: Moderate- to high-intensity, face-to-face programs	Dec. 2014	($34)	$40	($73)	($392)	($425)	($0.09)	43%

Health Care System Efficiency
Program name (click on the program name for more detail)	Date of last literature review	Total benefits	Taxpayer benefits	Non-taxpayer benefits	Costs	Benefits minus costs (net present value)	Benefit to cost ratio	Chance benefits will exceed costs
Transitional care programs to prevent hospital readmissions: Comprehensive programs	Dec. 2014	$2,081	$920	$1,161	($493)	$1,588	$4.22	66%
Transitional care programs to prevent hospital readmissions: All programs, general patient populations	Dec. 2014	$479	$201	$277	($61)	$418	$7.86	64%
Patient-centered medical homes in physician-led practices without explicit utilization or cost incentives (high-risk populations)	Dec. 2016	$320	$159	$161	($98)	$222	$3.27	49%
Patient-centered medical homes in physician-led practices with utilization or cost incentives (high-risk populations)	Dec. 2016	$246	$145	$101	($183)	$63	$1.35	43%
Interventions to reduce unnecessary emergency department visits: General education on appropriate ED use	Dec. 2014	$15	$6	$9	($9)	$6	$1.63	50%
Patient-centered medical homes in physician-led practices without explicit utilization or cost incentives (general population)	Dec. 2016	$44	$40	$4	($98)	($53)	$0.45	35%
Interventions to reduce unnecessary emergency department visits: Asthma self-management education for children	Dec. 2014	($5)	$12	($16)	($92)	($96)	($0.05)	45%
Patient-centered medical homes in physician-led practices with utilization or cost incentives (general population)	Dec. 2016	$60	$65	($5)	($183)	($123)	$0.33	32%
Interventions to reduce unnecessary emergency department visits: Intensive case management for frequent ED users	Dec. 2014	$9,611	$5,623	$3,988	($11,300)	($1,689)	$0.85	43%

Maternal and Infant Health
Program name (click on the program name for more detail)	Date of last literature review	Total benefits	Taxpayer benefits	Non-taxpayer benefits	Costs	Benefits minus costs (net present value)	Benefit to cost ratio	Chance benefits will exceed costs
Other prenatal home visiting programs	Dec. 2016	$13,675	$881	$12,794	($817)	$12,858	$16.74	100%
Smoking cessation programs for pregnant women: Contingency management	Dec. 2016	$11,670	$1,128	$10,543	($247)	$11,424	$47.33	98%
Enhanced prenatal care programs delivered through Medicaid	Dec. 2016	$7,453	$972	$6,481	($488)	$6,964	$15.26	98%
Group prenatal care (compared to standard prenatal care)	Dec. 2016	$3,204	$212	$2,992	$1,292	$4,495	n/a	94%
Smoking cessation programs for pregnant women: Nicotine replacement treatment	Dec. 2016	$3,975	$366	$3,610	($137)	$3,838	$29.05	75%
Non-Medicaid enhanced prenatal care programs for adolescents	Dec. 2016	$3,526	$739	$2,787	($603)	$2,923	$5.85	72%
Smoking cessation programs for pregnant women: Intensive behavioral interventions	Dec. 2016	$2,667	$240	$2,427	($112)	$2,555	$23.91	90%
Resource Mothers Program	Dec. 2016	$2,326	$410	$1,916	($844)	$1,482	$2.76	84%
Cesarean section reduction programs: Multi-faceted hospital-based interventions (Medicaid population)	Nov. 2015	$323	$229	$94	($40)	$283	$7.98	100%
Cesarean section reduction programs: Multi-faceted hospital-based interventions (private pay population)	Nov. 2015	$306	$0	$306	($40)	$265	$7.56	100%
Cesarean section reduction programs: Audit and feedback (Medicaid population)	Nov. 2015	$195	$141	$54	($32)	$162	$6.01	84%
Cesarean section reduction programs: Audit and feedback (private pay population)	Nov. 2015	$183	$0	$183	($32)	$150	$5.64	83%
Cesarean section reduction programs: Mandatory second opinion (Medicaid population)	Nov. 2015	$166	$141	$25	($91)	$76	$1.84	100%
Cesarean section reduction programs: Mandatory second opinion (private pay population)	Nov. 2015	$155	$0	$155	($91)	$64	$1.70	97%
Cesarean section reduction programs: Continuous support (Medicaid population)	Nov. 2015	($13)	$94	($107)	($307)	($320)	($0.04)	1%
Cesarean section reduction programs: Continuous support (private pay population)	Nov. 2015	($21)	$0	($21)	($307)	($328)	($0.07)	1%
Interventions to prevent excessive gestational weight gain (population with obesity-related risk factors)	Dec. 2016	($823)	($257)	($566)	($238)	($1,062)	($3.45)	46%
Interventions to prevent excessive gestational weight gain (general population)	Dec. 2016	($1,142)	$125	($1,267)	($217)	($1,359)	($5.27)	34%

Falls Prevention for Older Adults
Program name (click on the program name for more detail)	Date of last literature review	Total benefits	Taxpayer benefits	Non-taxpayer benefits	Costs	Benefits minus costs (net present value)	Benefit to cost ratio	Chance benefits will exceed costs
Multicomponent interventions including exercise and home hazard reduction (high-risk population)	Jan. 2018	$9,669	$1,290	$8,379	($1,144)	$8,525	$8.45	100%
Otago Exercise Program (high-risk population)	Jan. 2018	$7,190	$956	$6,234	($804)	$6,386	$8.94	97%
Home hazard reduction (high-risk population)	Oct. 2017	$4,142	$709	$3,433	($375)	$3,767	$11.04	100%
Otago Exercise Program (general population)	Jan. 2018	$4,237	$579	$3,658	($740)	$3,498	$5.73	100%
Group exercise classes (high-risk population)	Feb. 2018	$3,473	$607	$2,866	($408)	$3,066	$8.52	73%
Individual exercise programs (high-risk population)	Feb. 2018	$3,188	$413	$2,775	($684)	$2,504	$4.66	75%
Group exercise classes for osteoporosis/osteopenia	Jan. 2018	$783	$177	$606	($350)	$433	$2.23	79%
Multifactorial programs: physician-led (high-risk population)	Nov. 2017	$2,191	$557	$1,634	($1,779)	$412	$1.23	63%
Multicomponent interventions including exercise and home hazard reduction (general population)	Jan. 2018	$803	$164	$639	($394)	$409	$2.04	88%
Tai Chi (high-risk population)	Jan. 2018	$638	$139	$499	($261)	$377	$2.45	56%
Tai Chi (general population)	Jan. 2018	$619	$150	$469	($394)	$225	$1.57	79%
Group exercise classes (general population)	Feb. 2018	$201	$53	$148	($156)	$45	$1.29	59%
Individual exercise programs (general population)	Feb. 2018	$327	$93	$235	($315)	$13	$1.04	50%
Cognitive behavioral interventions (general population)	Feb. 2018	$329	$86	$242	($346)	($17)	$0.95	44%
Multifactorial interventions: nurse-led (general population)	Nov. 2017	$542	$153	$388	($786)	($244)	$0.69	20%
Home hazard reduction (general population)	Oct. 2017	($86)	$1	($87)	($185)	($271)	($0.46)	17%
Multicomponent interventions including group exercise and vitamin D supplementation (high-risk population)	Jan. 2018	($634)	$12	($646)	($1,378)	($2,012)	($0.46)	23%
Multifactorial interventions: nurse-led (high-risk population)	Nov. 2017	($5,798)	($689)	($5,109)	($662)	($6,460)	($8.76)	0%

To view details of all Health Care programs in a single pdf, click here.

Other Health Care topics reviewed; benefit-cost results not yet available:

Program name (click on the program name for more detail)	Date of last literature review	Notes
Accountable Care Organizations: (a) Alternative Quality Contract	Nov. 2015	Click for meta-analytic results
Accountable Care Organizations: (b) Medicare Physician Group Practice Demonstration (PGPD)	Nov. 2015	Click for meta-analytic results
Accountable Care Organizations: (c) Medicare Pioneer ACOs	Nov. 2015	Click for meta-analytic results
Cost sharing: (a) High-Deductible Health Plans (moderate to high deductibles, with and without HRAs or HSAs), general patient population	Nov. 2015	Click for meta-analytic results
Cost sharing: (b) High-Deductible Health Plans (moderate to high deductible levels, with or without HSAs), low-income patient population	Nov. 2015	Click for meta-analytic results
Cost sharing: (c) High-Deductible Health Plans with moderate deductibles (individual < $1000), general patient population	Nov. 2015	Click for meta-analytic results
Cost sharing: (d) High-Deductible Health Plans with higher deductibles (individual > $1000), general patient population	Nov. 2015	Click for meta-analytic results
Cost sharing: (e) High-Deductible Health Plans with higher deductibles (individual > $1000) and HRA accounts, general patient population	Nov. 2015	Click for meta-analytic results
Cost sharing: (f) High-Deductible Health Plans with higher deductibles (individual > $1000) and HSA accounts, general patient population	Nov. 2015	Click for meta-analytic results
Cost sharing: (g) Coinsurance (25% rate or higher) versus no cost sharing, general patient population	Nov. 2015	Click for meta-analytic results
Cost sharing: (h) Copay increases across multiple services, low-income population	Nov. 2015	Click for meta-analytic results
Cost sharing: (i) Copay increases across multiple services, low-income and chronically-ill population	Nov. 2015	Click for meta-analytic results
Cost sharing: (j) Emergency department copays, general patient population	Nov. 2015	Click for meta-analytic results
Cost sharing: (k) Emergency department copays, low-income patient population	Nov. 2015	Click for meta-analytic results
Cost sharing: (l) Copays for nonemergent emergency department visits, Medicaid adult population	Nov. 2015	Click for meta-analytic results
Cost sharing: (m) Copays for prescription drugs, general patient population	Nov. 2015	Click for meta-analytic results
Cost sharing: (n) Copays for prescription drugs, adults with a chronic illness	Nov. 2015	Click for meta-analytic results
Cost sharing: (o) Copay reductions for prescription drugs used to treat chronic conditions (Value Based Insurance Design), adults with chronic illnesses	Nov. 2015	Click for meta-analytic results
Cost sharing: (p) Copays for prescription drugs, low-income children (CHIP)	Nov. 2015	Click for meta-analytic results
Cost sharing: (q) Copays for prescription drugs, low-income children (CHIP) with a chronic illness	Nov. 2015	Click for meta-analytic results
Cost sharing: (r) Copays for prescription drugs, Medicare beneficiaries	Nov. 2015	Click for meta-analytic results
Falls prevention: Individual exercise programs for osteoporosis/osteopenia	Jan. 2018	Click for meta-analytic results
Long-acting reversible contraception (compared to short-acting reversible contraception)	Sep. 2018	Click for meta-analytic results
Non-Medicaid enhanced prenatal care programs for African-American women	Dec. 2016	Click for meta-analytic results
Oral health: Fluoride varnish treatment for permanent teeth	Oct. 2014	Click for meta-analytic results
Oral health: Fluoride varnish treatment for primary teeth	Oct. 2014	Click for meta-analytic results
Oral health: Resin sealants for molars	Oct. 2014	Click for meta-analytic results
Patient-centered medical homes in integrated health systems (high-risk population)	Dec. 2016	Click for meta-analytic results
Smoking cessation programs for pregnant women: Postpartum smoking relapse prevention	Dec. 2016	Click for meta-analytic results
Transitional care programs to prevent hospital readmissions: Brief phone follow-up only	Dec. 2014	Click for meta-analytic results
Chronic Care Model (CCM) interventions	Dec. 2016	No rigorous evaluation measuring outcome of interest.
Oral health: Mid-level dental care providers	Oct. 2014	No rigorous evaluation measuring outcome of interest.
Oral health: Preventive dental visits	Oct. 2014	No rigorous evaluation measuring outcome of interest.
Prenatal depression screening	Dec. 2016	No rigorous evaluation measuring outcome of interest.
Click to expand

Benefit-Cost Results

Benefit-cost methods last updated December 2023

Health Care

Other Health Care topics reviewed; benefit-cost results not yet available:

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