On the Evidence

Latest Episodes:

61 | Anita Summers on a Pioneering Career in Economics and Public Policy Research Sep 08, 2021

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Our guest for this episode of On the Evidence is Anita Summers, a former member of Mathematica's Board of Directors and a pioneer in the fields of economics and public policy research. Summer's career includes research posts with the National Bureau of Economic Research, Standard Oil, and the Federal Reserve Bank of Philadelphia. During her time at the Federal Reserve, she developed expertise in urban economic development and education. Summers has held a variety of academic appointments, including as a professor at the Wharton School of the University of Pennsylvania, where she started the first public policy department in a business school. From 1993 through 2019, Summers was also a member of Mathematica’s board of directors, serving as board chair for most of that time. On the latest episode of On the Evidence, Summers shares what it was like to embark on a career in economics as a woman in the 1940s, the sexism she encountered, how she navigated those challenges, and the role her family played in her career choices. As an early practitioner of using data and statistical analysis to inform contemporary policy debates, she also weighs in on how the field of evidence-based policy has changed and what lies ahead for the profession. Find a full transcript of the episode here: https://www.mathematica.org/blogs/reflections-on-a-pioneering-career-in-economics-and-public-policy-research Read Summers’s article from 1973 on equity in school financing for the Federal Reserve Bank of Philadelphia’s Business Review: https://fraser.stlouisfed.org/title/business-review-federal-reserve-bank-philadelphia-5580/march-1973-557534/equity-school-financing-523404 Read Summers’s article from 1975 on measuring the effect of school resources on learning for the Federal Reserve Bank of Philadelphia’s Business Review: https://fraser.stlouisfed.org/title/business-review-federal-reserve-bank-philadelphia-5580/february-1975-557556/school-resources-help-learning-efficiency-equity-philadelphia-public-schools-523479

60 | Lessons from a Successful Medicare Program Integrity Demonstration Aug 17, 2021

Show notes

Almost seven years ago, the Centers for Medicare & Medicaid Services (CMS) launched an initiative to test a possible solution to improper use of ambulance rides, long cited as a major source of waste and abuse in the Medicare program. The idea was pretty simple: Require companies that provide patients with repetitive, scheduled, non-emergent ambulance transport (RSNAT) for certain types of health care, such as dialysis or cancer treatments, to get prior authorization from CMS before providing service and submitting a claim for payment. Mathematica evaluated impacts of the initiative, which was implemented in the District of Columbia and eight states. Because non-emergency ambulance service use is rare in the Medicare program, the study focused on Medicare beneficiaries who are most likely to use RSNAT services—those with end-stage renal disease and/or severe pressure ulcers. Those two groups account for about 85 percent of Medicare RSNAT claims, so any change in use and spending would be most detectable among those patients. The most recent Mathematica evaluation found that, as a result of prior authorization, RSNAT costs declined by over 70 percent since the initiative started. Importantly, spending less on RSNAT services resulted in a decrease in overall Medicare fee-for-service spending of more than 2 percent, equal to about $1 billion since the initiative started. All of this occurred without any evidence of a decline in access to care or the quality of care beneficiaries received. Late last year, CMS announced that it would expand the use of prior authorization for RSNAT services nationwide. On this episode of On the Evidence, guests Amy Cinquegrani of CMS and Andrew Asher of Mathematica discuss lessons that could inform the national rollout as well as novel approaches for using data analytics to further reduce improper health care use and payments. Cinquegrani directs the Division of Payment Methods and Strategies at the Center for Program Integrity within CMS. Asher is a senior fellow at Mathematica, where he focuses on using data to help health care payers strengthen the integrity of their programs, realize cost savings, monitor programs, and improve program outcomes. Find a full transcript of the episode here: mathematica.org/blogs/lessons-from-a-successful-medicare-program-integrity-demonstration-soon-to-expand-nationwide Read a short fact sheet summarizing findings from the evaluation of the Medicare Prior Authorization Model for Repetitive Scheduled Non-Emergent Ambulance Transport: https://innovation.cms.gov/data-and-reports/2021/rsnat-finlevalrpt-fg Read the CMS announcement that the Medicare Prior Authorization Model for RSNAT would expand nationwide: https://www.cms.gov/newsroom/press-releases/cms-expand-successful-ambulance-program-integrity-payment-model-nationwide

59 | Lessons from Southwest Detroit's Efforts to Support Informal Child Care Aug 11, 2021

Show notes

Five years ago, the W.K. Kellogg Foundation, in partnership with the Kresge Foundation, launched Hope Starts Here, a community-focused, citywide initiative aimed at ensuring that all children in Detroit are prepared for kindergarten by increasing access to high quality early care and education. As part of the citywide initiative, Mathematica, with financial support from the Kellogg Foundation, worked to implement promising strategies to enhance the quality of informal child care, which is defined as unlicensed care provided by family, friends, and neighbors. Outside of care provided by a parent, informal child care is the most common form of care for infants and toddlers in the United States. The project focused on providing resources and support informal providers in southwest Detroit, one of 10 neighborhoods in the city where the number of children who need early care and education vastly exceeds the number of available, licensed slots. Even when a licensed slot is available, families may still prefer informal care because they believe the providers are more trustworthy, provide more culturally consistent care, and offer more affordable and convenient care. On the latest episode of On the Evidence, people involved in the effort to support informal child care in southwest Detroit reflect on the experience. Given how many families in United States rely on this form of care, insights on how to strengthen the quality of care and education offered by informal providers could help make the overall child care and early education system stronger and more equitable across the country. Guests for the episode are: • Linda Jackson, an informal care provider • Violeta Ramirez, an informal care provider • AleshaNicole, a teaching artist at Living Arts, a neighborhood nonprofit that provides arts education programs to engage and inspire youth, families, and teachers • Amanda Holiday, an early childhood specialist at Congress of Communities, a resident-led organizing and advocacy agency working for change in the areas of public safety and education • Eileen Storer Smith, a program officer at the W.K. Kellogg Foundation • Cleo Jacobs Johnson, a senior researcher at Mathematica Read the issue brief from Mathematica on supporting informal child care providers in southwest Detroit: http://mathematica.org/news/insights-from-a-community-collaborative-to-improve-informal-child-care-in-detroit Read a blog by Mathematica’s Mynti Hossain, Nazihah Siddiqui, and Cleo Jacobs Johnson about why supporting informal child care providers is key to advancing equity: mathematica.org/blogs/supporting-informal-child-care-providers-is-key-to-advancing-equity

58 | Learning from an Early Childhood Nonprofit that Serves Fathers Jun 23, 2021

Show notes

All over the country, federally funded Head Start programs promote the school readiness of young children ages birth through five from families with low incomes. These programs provide early education and a range of comprehensive services at no cost to the family. Although Head Start programs have historically empowered parents to be involved in their children’s learning and development, it’s been more common for mothers to be the focus of those efforts. Realizing the important role that fathers play in their children’s development and the family’s well-being, Head Start is increasingly working to engage fathers in program services. This episode of On the Evidence focuses on Bright Beginnings, a nonprofit in Washington, DC, that provides both center-based and home-based Head Start programming for children and families. It is notable for its robust set of services and supports that are designed to help families by helping fathers. The guests for this episode are Danielle DeLisle, a research analyst at Mathematica, and two employees at Bright Beginnings, Anthony Sessoms and Ryan Pratt. Sessoms oversees the nonprofit’s fatherhood initiative. Pratt is a maintenance technician at Bright Beginnings and a father who has participated in its fatherhood programming. This episode was made possible with support from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the U.S. Department of Health and Human Services. This episode returns to a topic On the Evidence has explored before: fathers’ engagement in human services programs. Fathers play an important role in their children’s development, and most fathers want to be involved with their children’s lives. However, many government and nonprofit programs were originally designed to serve women and children, and excluded fathers in the process. That’s starting to change. More government agencies, nonprofits, and researchers are exploring strategies that embrace fathers’ desire to be involved with their children. ASPE has partnered with Mathematica to study strategies for including and engaging fathers in social service programming. The ultimate goal is to better support the well-being of families. The episode has two parts: a long-form conversation about Bright Beginnings with Sessoms and Pratt, followed by a brief discussion with DeLisle about related research from Mathematica and ASPE. Learn more about the partnership between ASPE and Mathematica to identify the strategies human services programs use to engage fathers: https://aspe.hhs.gov/father-engagement Listen to a previous episode of On the Evidence about how fatherhood programs pivoted to keep engaging fathers during the COVID-19 pandemic: http://mathematica.org/blogs/how-fatherhood-programs-supported-dads-during-the-pandemic A transcript of the episode is available here: http://mathematica.org/blogs/new-insights-from-an-early-childhood-nonprofit-that-supports-fathers Help us improve the show. Please take our listener survey at tinyurl.com/ontheevidence. Upon completion of the survey, you will be given the option to provide an email address that will be entered into a drawing for a chance to win a $50 e-gift card.

57| Your Contact Tracing Workforce Can Drive Equity and Mitigate Infectious Disease Risks May 12, 2021

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Contact tracing is an important public health tool for containing the spread of disease, including COVID-19. But contact tracers are effective only if they can persuade people to answer questions about recent whereabouts and who else might have been exposed. Contact tracers are more likely to be successful in their outreach if they and the people they are contacting have similar backgrounds. Currently, no one collects and reports information on the composition of the COVID-19 workforce in communities across the country, making it difficult to know whether the workforce could be more effective with focused recruitment strategies. However, a partnership between Mathematica and the Public Health Foundation sheds some light on who is engaged in contact tracing during the pandemic and how their backgrounds compare with the backgrounds of people in their local communities. On this episode of On the Evidence, guests Ilya Plotkin and Jia Pu discuss an interactive dashboard that uses a large and unique national data set to visualize demographic data of COVID-19 contact tracing trainees and the communities they serve. • Plotkin is the director of the TRAIN Learning Network, a service of the Public Health Foundation that provides a clearinghouse of learning opportunities, including free training on contact tracing, for health professionals. Although it is not the only source of training on contact tracing, it is one of the largest. As of early April 2021, more than 40,000 people participated in its training on COVID-19 contact tracing. • Pu is a health researcher at Mathematica who led the development of the dashboard based on data from the TRAIN Learning Network and other sources. During the podcast, Plotkin and Pu share how their personal backgrounds as part of Russian and Chinese immigrant communities in the U.S. motivated them to develop a resource for culturally sensitive, equitable, and effective contact tracing during the pandemic. They discuss potential applications of the dashboard and important limitations of the data. They also explain why contact tracing, as a tool for controlling and preventing disease spread, will only grow in importance as more people are vaccinated, infections decline, and more parts of the economy, such as schools and offices, reopen. Find a transcript of the conversation here: https://bit.ly/3w1LGKP Read a blog post by Ilya and Jia that provides further context about the COVID-19 contact tracing workforce dashboard: https://bit.ly/2Q3IEpY Explore the COVID-19 contact tracing workforce dashboard: https://bit.ly/3tB2DtK Email CTINFO@mathematica-mpr.com if you would like your information about the contact tracing workforce to be included in the dashboard. 9XncXvdUP3gYNrav9j5B

56 | How Fatherhood Programs Supported Dads During the Pandemic Apr 28, 2021

Show notes

In partnership with the Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the U.S. Department of Health and Human Services, Mathematica has been gathering information on what works in engaging fathers across a wide range of human services programs, with the goal of helping fathers and families thrive. The COVID-19 pandemic has disrupted many of the typical ways organizations support fathers and their families, but it has also provided motivation to be creative, to adapt, and to experiment with digital services that have certain advantages in helping fathers meet their goals over traditional in-person services. On this episode of On the Evidence, guests John Ward, Sean Wilson, Richard Barr, Kirk Berry, and Rebekah Selekman discuss COVID-19’s implications for delivering fatherhood engagement services during and after the pandemic. • Ward is a father who shares experience working with a local nonprofit, Father to Father, in Charleston, SC. • Wilson is an intervention specialist at Father to Father who worked with Ward. • Barr is the vice president of strategic and organizational development at the South Carolina Center for Fathers and Families, a statewide nonprofit that operates six local fatherhood organizations, including Father to Father. • Berry is an expert on responsible fatherhood programs at Public Strategies, a public policy research and consulting firm. • Selekman is a researcher at Mathematica leading the KEEP Fathers Engaged project with ASPE. Find a full transcript of the episode here: https://bit.ly/3aNxOvp Learn more about the partnership between ASPE and Mathematica to identify strategies used to engage fathers across human service programming: https://aspe.hhs.gov/father-engagement Some of the clips from this episode come from a webinar hosted by the American Public Human Services Association (APHSA). We thank APHSA for allowing us to use clips from its Third Thursday Virtual Mini-Series, which is available here: https://www.aphsathirdthursday.com/ Help us improve the show. Please take our listener survey at tinyurl.com/ontheevidence Upon completion of the survey, you will be given the option to provide an email address that will be entered into a drawing for a chance to win a $50 e-gift card.

55 | A Conversation about Diversity, Equity, and Justice Apr 21, 2021

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On this episode of On the Evidence, guests Patricia A. King, LaVerne H. Council, and Akira Bell discuss diversity in evidence-based public policy and how it relates to issues of inclusion and justice. They are all members of Mathematica's Board of Directors who recently helped develop the company's aspirational vision that by 2035, "Mathematica is shaping an equitable and just world in which evidence drives decisions for global impact." They bring unique perspectives as Black women who are leaders in the fields of law, medicine, and technology. Patricia is a professor emerita at Georgetown Law. LaVerne is a founder and the chief executive officer of Emerald One, which works with mission-driven leaders and organizations to create and execute business and technology strategies that enact positive change. Akira is a senior vice president and the chief information officer at Mathematica. Find a full transcript of the episode here: https://bit.ly/3dXAZmc Find LaVerne's podcast, Brilliant in 20 here: https://bit.ly/3tvrfFe Find Akira's blog on ensuring that data security, privacy, and ethics are at the heart of the digital transformation occurring at Mathematica and other evidence-building organizations: https://bit.ly/3e81hB5 Read an interview with Pat about the 25th anniversary of the Belmont Report here: https://bit.ly/3uOgTAC Read an interview with Pat about her career as a civil rights leader here: https://bit.ly/3tp5Hu0 Help us improve the show. Please take our listener survey at tinyurl.com/ontheevidence Upon completion of the survey, participants can choose to enter a drawing for a chance to win a $50 e-gift card.

54 | The Value and Feasibility of COVID-19 Testing in K-12 Schools Mar 31, 2021

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In late March, the Biden administration announced that it was investing $10 billion to ramp up COVID-19 screening testing to help schools reopen. The expansion of screening tests in schools follows a February report from Mathematica that drew lessons from the experiences of six pilot sites that implemented COVID-19 testing in schools. These pilot programs—in Central Falls, Rhode Island; Los Angeles, California; Tulsa, Oklahoma; New Orleans, Louisiana; Louisville, Kentucky; and Washington, DC—were conducted with support from the Rockefeller Foundation, the Duke-Margolis Center for Health Policy, and Johns Hopkins University. The report provided insights about the acceptability, feasibility, and effectiveness of adding a testing program to schools’ existing COVID-19 related plans. For this episode of On the Evidence, guests Jennifer Harper, Sarah Hanck, and Divya Vohra discuss findings from the Mathematica report, impacts of the report so far, more recent lessons based on Tulsa’s experience implementing testing, and what leaders in schools and communities across the country need to know about using antigen testing as a screening tool. Harper is the project manager for COVID antigen testing in schools in Tulsa. Hanck is a senior advisor at the Rockefeller Foundation for strategy and impact who has provided guidance and support to Mathematica as it gathered evidence about antigen testing in the six pilot sites. Vohra is a senior researcher at Mathematica who coauthored the report on the pilots. Read Mathematica's report on the partnership between six pilot sites and the Rockefeller Foundation to implement COVID-19 rapid antigen tests in schools: mathematica.org/news/research-supported-by-the-rockefeller-foundation-strengthens-the-evidence-base-for-reopening-k-12 Help us improve the show. Please take our listener survey at tinyurl.com/ontheevidence Upon completion of the survey, you will be given the option to provide an email address that will be entered into a drawing for a chance to win a $50 e-gift card.

53 | Using Evidence to Guide Employment Assistance Strategies during and after the Pandemic Mar 10, 2021

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March 2021 marks the one-year anniversary of the World Health Organization officially declaring the coronavirus outbreak a pandemic. The disease we’ve come to know as COVID-19 has now infected more than 28 million Americans and led to at least half a million deaths in the United States. COVID-19 has also incurred serious damage to the nation’s economy. In February, the number of unemployed persons was 10 million, up from 5.7 million a year earlier. On this episode of On the Evidence, guests George Putnam, Dana Rotz, and Naihobe Gonzalez discuss the current distressed economy and evidence-based ideas about how to help workers who have been negatively affected by the pandemic. • Putnam, the labor market information director at the Illinois Department of Employment Security, helps the Midwest Collaborative, a consortium of nine states that share current administrative data across sectors and state lines to develop insights to support reemployment and economic recovery efforts. • Rotz is a senior researcher at Mathematica who leads a team at Mathematica that is producing short summaries of research related to pressing employment issues during the pandemic. • Gonzalez is also a senior researcher at Mathematica who coauthored a recent report for the U.S. Department of Education on findings from two experiments that allowed the use of Pell Grants to help displaced workers earn credentials that might quickly improve a person’s job prospects. To find a written transcript of the episode and to learn more about the data and research discussed on this episode, visit mathematica.org/commentary/using-evidence-to-guide-employment-assistance-strategies-during-and-after-the-pandemic. Help us improve the show. Please take our listener survey at tinyurl.com/ontheevidence Upon completion of the survey, you will be given the option to provide an email address that will be entered into a drawing for a chance to win a $50 e-gift card.

52 | Supporting Economic Mobility Through Coaching and Navigation Feb 24, 2021

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Nearly a year after COVID-19 took root in the United States, Americans are still dealing with the pandemic’s economic fallout. In January 2021, more than 10 million Americans were unemployed, up from roughly 5.8 million a year earlier. On this episode of On the Evidence, four guests discuss an increasingly popular approach for helping people find jobs and achieve other, related goals that provide economic security, such as getting a GED, buying a car, and improving a credit score. The approach combines two related services called coaching and navigation. The Bill & Melinda Gates Foundation partnered with Mathematica to better understand what coaching and navigation look like in practice, how the approaches are helping people through remote services during the pandemic, how they can be used to address racial and social inequities, and what evidence currently exists about their efficacy. In addition to hosting a virtual convening and producing a series of issue briefs on the topic, Mathematica invited the following experts involved with coaching and navigation to share their experiences on this episode of On the Evidence: - Ty Wright, a community engagement coordinator at AppleTree Early Learning Public Charter School, who has benefited from coaching and navigation - Lucy Smart, the program coordinator of parent engagement for LIFT-DC, who also provides coaching services - Brian Marroquin, a senior program director for LIFT, a national nonprofit that provides coaching and navigation services in four cities - Sheena McConnell, a senior fellow at Mathematica who studies employment programs that help vulnerable families Read about current knowledge on the effectiveness of coaching and navigation in facilitating economic mobility: https://bit.ly/37IZgc9 Help us improve the show. Please take our listener survey. Find it at the link below: tinyurl.com/ontheevidence Upon completion of the survey, you will be given the option to provide an email address that will be entered into a drawing for a chance to win a $50 e-gift card.

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