Understanding Cost Implications of the Pennsylvania Department of Health's Regionalization Process for its Tobacco Control Program

Background: The Tobacco Settlement Act of 2001 established a comprehensive tobacco use prevention and cessation program within the Pennsylvania Department of Health (PA DOH) with funding through the Master Settlement Agreement (MSA). After the first four years, PA DOH embarked on a process to replace the existing structure of local programming at the county level (48 primary contractors responsible for the 67 counties in Pennsylvania) with a regional-level administrative structure consisting of 8 regions and 8 primary contractors. This move towards regionalization was supported by cost and efficiency-related arguments that suggested increased benefits for Pennsylvania's TPC including the emergence of economies of scale, an overall reduction of administrative costs, and greater specialization by tobacco control employees. Discussion: This poster presents the results of research conducted by Pennsylvania's statewide evaluators, Philadelphia Health Management Corporation and Branch Associates, Inc., on possible implications of this regionalization, including advantages and disadvantages of regionalization across each cost-argument. The poster also presents a strategy to evaluate the impact of regionalization including collecting data about unit costs, labor hours (with an emphasis on administrative hours), and employee specialization