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The SSRC Library allows visitors to access materials related to self-sufficiency programs, practice and research. Visitors can view common search terms, conduct a keyword search or create a custom search using any combination of the filters at the left side of this page. To conduct a keyword search, type a term or combination of terms into the search box below, select whether you want to search the exact phrase or the words in any order, and click on the blue button to the right of the search box to view relevant results.

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  • Individual Author: Zogg, Cheryl K.; Scott, John W.; Metcalfe, David; Gluck, Abbe R.; Curfman, Gregory D.; Davis, Kimberly A.; Dimick, Justin B.; Haider, Adil H.
    Reference Type: Journal Article
    Year: 2019

    Importance Trauma is a leading cause of death and disability for patients of all ages, many of whom are also among the most likely to be uninsured. Passage of the Patient Protection and Affordable Care Act was intended to improve access to care through improvements in insurance. However, despite nationally reported changes in the payer mix of patients, the extent of the law’s impact on insurance coverage among trauma patients is unknown, as is its success in improving trauma outcomes and promoting increased access to rehabilitation.

    Objective To use rigorous quasi-experimental regression techniques to assess the extent of changes in insurance coverage, outcomes, and discharge to rehabilitation among adult trauma patients before and after Medicaid expansion and implementation of the remainder of the Patient Protection and Affordable Care Act.

    Design, Setting, and Participants Quasi-experimental, difference-in-difference analysis assessed adult trauma in patients aged 19 to 64 years in 5 Medicaid expansion (Colorado,...

    Importance Trauma is a leading cause of death and disability for patients of all ages, many of whom are also among the most likely to be uninsured. Passage of the Patient Protection and Affordable Care Act was intended to improve access to care through improvements in insurance. However, despite nationally reported changes in the payer mix of patients, the extent of the law’s impact on insurance coverage among trauma patients is unknown, as is its success in improving trauma outcomes and promoting increased access to rehabilitation.

    Objective To use rigorous quasi-experimental regression techniques to assess the extent of changes in insurance coverage, outcomes, and discharge to rehabilitation among adult trauma patients before and after Medicaid expansion and implementation of the remainder of the Patient Protection and Affordable Care Act.

    Design, Setting, and Participants Quasi-experimental, difference-in-difference analysis assessed adult trauma in patients aged 19 to 64 years in 5 Medicaid expansion (Colorado, Illinois, Minnesota, New Jersey, and New Mexico) and 4 nonexpansion (Florida, Nebraska, North Carolina, and Texas) states.

    Interventions/Exposure Policy implementation in January 2014.

    Main Outcomes and Measures Changes in insurance coverage, outcomes (mortality, morbidity, failure to rescue, and length of stay), and discharge to rehabilitation.

    Results A total of 283 878 patients from Medicaid expansion states and 285 851 patients from nonexpansion states were included (mean age [SD], 41.9 [14.1] years; 206 698 [36.3%] women). Adults with injuries in expansion states experienced a 13.7 percentage point increase in discharge to rehabilitation (95% CI, 7.0-7.8; baseline: 14.7%) that persisted across inpatient rehabilitation facilities (4.5 percentage points), home health agencies (2.9 percentage points), and skilled nursing facilities (1.0 percentage points). There was also a 2.6 percentage point drop in failure to rescue and a 0.84-day increase in length of stay. Rehabilitation changes were most pronounced among patients eligible for rehabilitation coverage under the 2-midnight (8.4 percentage points) and 60% (10.2 percentage points) Medicaid payment rules. Medicaid expansion increased rehabilitation access for patients with the most severe injuries and conditions requiring postdischarge care (eg, pelvic fracture). It mitigated race/ethnicity-, age-, and sex-based disparities in which patients use rehabilitation.

    Conclusions and relevance This multistate assessment demonstrated significant changes in insurance coverage and discharge to rehabilitation among adult trauma patients that were greater in Medicaid expansion than nonexpansion states. By targeting subgroups of the trauma population most likely to be uninsured, rehabilitation gains associated with Medicaid have the potential to improve survival and functional outcomes for more than 60 000 additional adult trauma patients nationally in expansion states. (Author abstract)

  • Individual Author: Hamadyk, Jill; Gardiner, Karen
    Reference Type: Report
    Year: 2019

    This brief summarizes the experiences of leaders and staff from eight career pathways programs that participated in the Pathways for Advancing Careers and Education (PACE) Evaluation. Based on firsthand accounts, the brief describes how staff perceived the benefits of participating in the randomized controlled trial (RCT) evaluation, the challenges they experienced—in particular recruiting study participants and implementing its random assignment procedures—and how they overcame challenges. The brief then describes lessons staff learned from participating in PACE. The insights presented below will be helpful for future evaluation teams as they approach potential study sites, as well as for programs considering participating in a rigorous evaluation. (Edited author introduction)

     

    This brief summarizes the experiences of leaders and staff from eight career pathways programs that participated in the Pathways for Advancing Careers and Education (PACE) Evaluation. Based on firsthand accounts, the brief describes how staff perceived the benefits of participating in the randomized controlled trial (RCT) evaluation, the challenges they experienced—in particular recruiting study participants and implementing its random assignment procedures—and how they overcame challenges. The brief then describes lessons staff learned from participating in PACE. The insights presented below will be helpful for future evaluation teams as they approach potential study sites, as well as for programs considering participating in a rigorous evaluation. (Edited author introduction)

     

  • Individual Author: Joyce, Kristen; McConnell, Sheena
    Reference Type: Report
    Year: 2019

    Together with the Office of Planning, Research, and Evaluation within the Administration for Children and Families, Mathematica and its partners Abt Associates and MDRC are examining the effectiveness of using coaches to help low-income individuals work toward self-sufficiency through the Evaluation of Employment Coaching for Temporary Assistance for Needy Families (TANF) and Related Populations. The coaching programs participating in the evaluation implement distinct approaches to employment coaching, as described in these four program snapshots:

    • FaDSS program snapshot
    • Goal4 It!TM program snapshot
    • LIFT program snapshot
    • MyGoals program snapshot

    (Author introduction)

    Together with the Office of Planning, Research, and Evaluation within the Administration for Children and Families, Mathematica and its partners Abt Associates and MDRC are examining the effectiveness of using coaches to help low-income individuals work toward self-sufficiency through the Evaluation of Employment Coaching for Temporary Assistance for Needy Families (TANF) and Related Populations. The coaching programs participating in the evaluation implement distinct approaches to employment coaching, as described in these four program snapshots:

    • FaDSS program snapshot
    • Goal4 It!TM program snapshot
    • LIFT program snapshot
    • MyGoals program snapshot

    (Author introduction)

  • Individual Author: Levy, Diane K. ; Edmonds, Leiha; Simington, Jasmine
    Reference Type: Report
    Year: 2018

    This brief presents information on work requirement policies implemented by public housing agencies and estimates the percent of households affected by the requirements. Noting the lack of evidence on the outcomes and effects of work requirements on households’ employment and income and on the agencies’ implementation costs, it closes with questions to guide future research and policy considerations. (Author abstract) 

    This brief presents information on work requirement policies implemented by public housing agencies and estimates the percent of households affected by the requirements. Noting the lack of evidence on the outcomes and effects of work requirements on households’ employment and income and on the agencies’ implementation costs, it closes with questions to guide future research and policy considerations. (Author abstract) 

  • Individual Author: Eyster, Lauren; Barnow, Burt S.; Anderson, Theresa; Conway, Maureen; Lerman, Robert I.; Jain, Ranita; Kuehn, Daniel; Montes, Marcela
    Reference Type: Report
    Year: 2018

    This brief summarizes findings from implementation, impact, and cost-benefit evaluations of Accelerating Opportunity (AO). AO is a career pathways initiative launched in 2011 that aims to help adults with low basic skills earn valued occupational credentials, obtain well-paying jobs, and sustain rewarding careers. AO was one of the first efforts to replicate and scale key elements of Washington state's Integrated Basic Education and Skills Training (I-BEST) model. The evaluation took place in Illinois, Kansas, Kentucky, and Louisiana. The evidence shows that AO holds promise for changing college systems and promoting educational gains among low-skilled adults. Earnings impacts are mixed. (Author abstract) 

    This brief summarizes findings from implementation, impact, and cost-benefit evaluations of Accelerating Opportunity (AO). AO is a career pathways initiative launched in 2011 that aims to help adults with low basic skills earn valued occupational credentials, obtain well-paying jobs, and sustain rewarding careers. AO was one of the first efforts to replicate and scale key elements of Washington state's Integrated Basic Education and Skills Training (I-BEST) model. The evaluation took place in Illinois, Kansas, Kentucky, and Louisiana. The evidence shows that AO holds promise for changing college systems and promoting educational gains among low-skilled adults. Earnings impacts are mixed. (Author abstract) 

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