Outcome should be determined based on identified needs and client satisfaction. Cost effectiveness relates to maximizing funding - getting the most for a dollar. In measuring cost effectiveness, a balance must be struck between cost and quality, and it is important to differentiate between costs and charges. The planning council, through the comprehensive planning process, should define the continuum of care in the region and identify measurable outcome objectives and performance indicators that would be beneficial for planning, prioritizing and implementing health care and support service strategies and interventions. These indicators might include such measures as percentage of clients with CD4 counts below 200 receiving PCP prophylaxis, percentage of substance abuse clients who are screened for TB, level of perinatal transmission, etc.
Core elements are definable parts of a larger service category.
The grantee is responsible for incorporating these definitions and measurements into their contracts and providing feedback to the planning council as necessary. This process of determining cost and outcome effectiveness should be provider and consumer driven and might consist of ad-hoc working groups of the planning council, public forums, etc. This process should be ongoing, with analysis of 2-3 service priorities each year until the full continuum is addressed. Information derived from this process should be made available to the planning council in a timely manner to be useful in the annual priority setting process. The planning council also has the responsibility to evaluate the effectiveness of the services procured by the grantee in meeting the need identified within planning council priorities.