142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

298711
Assessing Variation in Revenue Generating Strategies of Local Health Departments

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Sergey Sotnikov, PhD , Office for state tribal local and territorial support, CDC, Atlanta, GA
Huabin Luo, PhD , Office for state tribal local and territorial support, CDC, Atlanta, GA
Tim van Wave, PhD , Office for state tribal local and territorial support, CDC, Atlanta, GA
Research objective: Local health departments (LHDs) rely on funding from various revenue sources (state, local, and federal funds, etc). The purpose of the study is to describe the relative contribution of these funding sources and evaluate how LHD revenue-generating strategies (broad diversification vs. reliance on one revenue source) are associated with the overall level of LHD spending.

Study design: We used  data from the 2010 National Profile of Local Health Departments Study (Profile study), where LHD directors were asked to apportion LHD revenues (in %) using the following  categories: City/township/town, County, State, Tribal, Federal, Medicaid, Medicare, Private foundations, Private health insurance, Patient personal fees,  and Non-clinical fees and fines. Each LHD revenue source pattern can be described on a continuum from well-diversified to highly dependent on one source.  We calculated a degree of diversification of revenues for each LHD using the Herfindahl index. The revenue stream is considered to be well diversified if Herfindahl index (defined as a sum of squared shares of all revenue sources) is below the threshold point of 1500. The dependence on sole revenue source was assessed by creating several subsets of LHDs with one revenue source constituting more than 50% of total revenues. For each of these groupings the per capita spending statistic has been calculated.

Population studied: A sample of 1,363 LHDs that participated in the NACCHO 2010 Profile study.

Principal findings: The LHDs with well-diversified revenues (Herfindahl index <1500) spent $93/capita, 55% more than the sample’s average of $60/capita. LHDs receiving more than 50% of their revenue from Medicaid spent $120/per capita, twice the sample average.  

Conclusion: LHDs using a strategy of well-diversified revenue sources was positively associated with higher levels of LHD per capita spending. LHDs relying on Medicaid as principal source of revenue were also associated with higher level of LHD per capita spending.

Learning Areas:

Public health administration or related administration
Public health or related research

Learning Objectives:
Name 2 strategies that can be used by Local Health Departments to maximize revenues

Keyword(s): Local Public Health Agencies, Funding/Financing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in its development
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.