Step 3: Identify and Categorize Benefits

After documenting the program's inputs and costs, the next step is to identify the benefits the program creates. It is important to decide which benefits are relevant for analysis.

Types of Benefits

• Healthcare cost savings: Fewer avoidable hospital stays or emergency department visits
• Better health outcomes: Improved physical or mental health among participants
• Improvements in social determinants of health: Increased access to food, housing, transportation, or other supports
• Productivity gains: Fewer missed workdays or improved ability to work
• Community or system-wide benefits: Stronger partnerships, better coordination of resources, and improved access to services
• Other program results: New services offered, more participants reached, or other measurable outputs

Benefits may appear in the short term, medium term, or long term. Programs should capture both measurable benefits and less tangible ones whenever possible, since both contribute to understanding the value of the program.

To calculate ROI, benefits must ultimately be assigned a dollar value. This step allows rural program leaders to compare the value of benefits compared to the costs.

In the Healthy Heart Education Program example, rural program leaders identified several types of benefits:

• Healthcare cost savings:
  • Fewer emergency department visits for uncontrolled hypertension
  • Fewer short hospital stays related to heart complications
• Health outcomes:
  • Improved blood pressure control reported by participants
  • Increased follow‑up with primary care providers
• Productivity gains:
  • Fewer missed workdays due to preventable health events
• Community benefits:
  • Stronger partnerships between the hospital and community organizations

Monetizing Benefits

Not all benefits can be monetized. In the Healthy Hearts Education Program, benefits include:

• Avoided emergency department visits:
  • Program data show 45 fewer emergency department visits compared to baseline
  • Average cost per emergency department visit = $2,500
  • 45 x $2,500 = $112,500
  • Estimated savings = $112,500
• Avoided hospital admissions:
  • 20 fewer short hospital stays
  • Average cost per stay = $8,000
  • 20 x $80,000 = $160,000
  • Estimated savings = $160,000
• Productivity gains:
  • Estimated 250 workdays saved
  • Valued at an average daily wage of $143 per day
  • Estimated value = $35,750

Total monetized benefits = $308,250

Other benefits, such as stronger partnerships, are described qualitatively (see Step 5: Interpret and Communicate Findings).