The Center's Return on Community Investment

April 2019

In a world of scarce resources, it is critical that programs are carefully assessed and evaluated to determine the return on community and public investment. Cost benefit analysis or return on community investment (ROCI) is a methodology for measuring the value to the community and constituents. An economist provided a ROCI in 2018 for three of The National Rural Health Resources' (The Center) programs funded by the Federal Office of Rural Health Policy.

Purpose: to assist The Center in improving documentation to demonstrate stronger measurable outcomes and improve program planning and services for federally funded programs.

Value is tied to Health Resources and Services Administration goals for work being done in rural health. These include:

  • Improving access to health care by strengthening the financial viability of rural health care providers
  • Addressing issues related to the rural health care work force
  • Building healthy communities

The community benefits of The Center’s programs are based on the knowledge and behavioral change of the participants that include hospitals, networks, and state rural health grantees. Social benefits are generated when participants implement interventions and undertake new behaviors and actions.

ROCI assesses the economic value that can be attributed to the technical assistance (TA) provided by The Center.

Center Programs Demonstrate Positive ROCI

  • TASC: $5.22 return for every dollar invested
  • SRHT: $1.09 return for every dollar invested in education and $1.08 for consultations 
  • Network: $7.89 per dollar invested in the Rural Network Allied Health Training TA 

ROCI increased over 2017 values for all three programs.

Kirkpatrick Taxonomy for Learning was Used to Guide the Evaluation. 

The Kirkpatrick/Phillips Model

* Capabiliti by Qustn for Kirkpatrick Employee Training

  • In TASC and SRHT that are hospital focused programs, the total ROCI is based on hospital operating margin, productivity, revenue, and impact of training. 
  • For the Rural Network program, it is expected that the total ROCI from the new jobs generated by the Allied Health Training via the networks is due in-part to program TA.

In 2018, the improved results are likely due to better data collection and documentation efforts, as well as new job opportunities via training and network activities. 

The Center will follow recommendations to increase the ROCI results in 2019 by continuing to improve processes that document outcomes.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,100,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.