Mathematica Policy Research

Research from Mathematica's disability experts offers findings on programs to help move people with disabilities off the beneficiary rolls & into employment. As part of the 7-year evaluation of the Ticket to Work program, a recent report looks at the experiences of employment service providers after the Social Security Administration revised regulations to address challenges in the original program. The SSA successfully educated providers about revised regulations & instituted related supports.

Despite more than $428 billion in spending in FY2008 to assist working-age people with disabilities, services provided are often fragmented, confusing, & less effective than they could be. This brief explains how the government serves a caretaker role. Authors point out that this model runs contrary to the goal of maximizing self-sufficiency embraced by the Americans with Disabilities Act & fails to direct funds to help those with disabilities join, remain in, or return to the workforce.

Summary presents key findings from a collection of nine studies conducted in 2009–2010, focusing on the employment efforts of working-age (age 18 to full retirement). Three of these reports concern TTW participants and program issues, while the other 6 are studies on more general topics related to beneficiary employment and SSA work supports. These nine studies constitute the fifth report of the Ticket to Work program evaluation.

To improve beneficiary care and reduce unnecessary expenditures, a number of states have developed programs and initiatives aimed at improving the coordination and management of care for dual eligibles—beneficiaries enrolled in both Medicaid and Medicare for their health care services. This report reviews the experiences in nine states to determine the lessons that can be learned from experience.

The impact of disability is wide ranging, influencing nearly every aspect of affected individuals’ lives, including how they seek and receive health care, how they process information, and what level of independence and community participation they enjoy. Evidence-based care has potential to improve the lives of American adults with disabilities. This brief presents methodological and design issues for researchers to consider.

Adults with disabilities have diverse, complex, and expensive needs for health care services, costing the health care system $398 billion in 2006. This group, which represented 14 percent of the adult population in 2008, will grow larger in the future. This report discusses study designs and outcome measures that can be used to address different comparative research questions. Policymakers, practitioners, and the public need a better understanding of what works for study designs.

Mathematica released the sixth report in a series that use the latest data available on MFP grants and state efforts to transition Medicaid enrollees to community living and rebalance LTC systems. The report presents survey results showing change in quality of life, quality of care and community integration reported by 803 MFP participants after one year of community living. The authors explore policy implications for MFP and other transition programs.

A growing number of individuals with disabilities are leaving the workforce and obtaining SSDI. Statistics show that the household incomes of these workers are falling behind those of workers without disabilities. This brief lays out a two-pronged approach for bending these curves—increasing the employment rate for people with disabilities, reducing their reliance on federal support, and increasing their household incomes—while preserving benefits for those who are unable to work.

Are MIGs assisting individuals with disabilities to become employed? This report shows the continued impact of MIG funding in 2009. One of the most visible activities has been the development of state Medicaid Buy-In programs, under which workers with significant disabilities can “buy in” to Medicaid coverage when their earnings would otherwise make them ineligible. This report updates trends in the enrollment, employment, and earnings of participants.

This report profiles MFP participants who transitioned from institutions to qualified home or community-based residences from the program start until June 2010. It finds that the majority eligible in 2007 was older adults living in nursing facilities; the largest group of MFP participants by mid-2010 has been people with physical disabilities under 65 who had lived in nursing homes. The report discusses discrepancy and describes recent policy and program changes that might narrow the difference.