| Expense Type | Definition | Example |
|---|---|---|
| Start-up | Expenses specifically incurred in preparation for delivery of the intervention | Value of staff time spent planning intervention, acquired assets (eg, HIT), or training new or existing staff |
| Developmental start-up | Start-up expenses incurred in establishing the foundation of the intervention and typically unrelated to the scale of implementation | Value of staff time spent on intervention planning, negotiating intra- or inter-organizational agreements, creating intervention tools, or re-tooling HIT systems |
| General start-up | Start-up expenses incurred to initiate a developed intervention and typically related to the scale of implementation | Value of staff time spent on intervention training or purchased assets (eg, computers, software, screening tools) needed to implement the intervention |
| Ongoing | Expenses specifically incurred in delivering the intervention | Direct and administrative staff time, assets, or supplies used to provide intervention |
| Effort | Any expense incurred in support of the ACT intervention, regardless of whether the expense emanated from new or existing resources | Value of time spent on intervention by existing staff and staff newly hired to accomplish intervention. Use of existing facilities and supplies and newly acquired assets specific to the intervention |
| Incremental | Expenses emanating only from new (additional) resources acquired to develop or implement the intervention. | Value of time spent on intervention by staff newly hired to accomplish intervention or newly acquired assets specific to the intervention |
| Direct staff | Expenses incurred to compensate patient facing staff involved in the intervention | Value of time spent by clinical or front desk staff that interact with patients in preparing for or providing intervention |
| Administrative staff | Expenses incurred to compensate staff supporting intervention without direct patient interaction. | Value of time spent by practice management, clinical supervisors, HIT or other support staff in preparing for or providing intervention. |
| Non-staff direct | Non-staff expenses for items that could be directly and entirely tied to the intervention | Computers, software, license fees, supplies, or travel purchased specifically to accomplish intervention |
| Overhead | Non-staff expenses that could be attributed in part to the intervention, but are neither distinctly nor entirely associated with it | Portions of rent, utilities or other pooled or general practice expenses that can be allocated or assigned to intervention activities |
Abbreviation: HIT, health information technology.