U.S. Department of Health and Human Services
An Analysis of Site-Specific Results
Robert A. Applebaum, Randall S. Brown and Peter Kemper
Mathematica Policy Research, Inc.
This report was prepared under contract #HHS-100-80-0157 between the U.S. Department of Health and Human Services (HHS), Office of Social Services Policy (now the Office of Disability, Aging and Long-Term Care Policy) and Mathematica Policy Research, Inc. For additional information about the study, you may visit the DALTCP home page at http://aspe.hhs.gov/daltcp/home.htm or contact the office at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC 20201. The e-mail address is: webmaster.DALTCP@hhs.gov. The DALTCP Project Officer was Robert Clark.
The major objective of the research was to evaluate the two models of channeling implemented in the demonstration. Results have been reported at the model level in a series of technical reports on channeling's impacts on nursing home use, hospital use and mortality, formal service use, case management, quality of life, and informal care. In this report we examine the site-specific impacts across these measures in an effort to determine whether any one site or group of sites was more successful than others in achieving the objectives initially set for the channeling project, and if so, what factors might be responsible for their greater success.1 Summary tables in the report provide an overview of site impacts, the appendix contains detailed site-specific impact estimates for key outcome measures used in the evaluation.
This report serves as a supplement to the channeling evaluation technical reports. These reports examine overall channeling impacts across a series of outcome measures based on sample member interview data collected at 6-, 12-, and 18-month intervals, primary informal caregiver interview data collected at 6- and 12-month intervals, Medicaid and Medicare records, a review of state death records, and an extract of provider service and cost records. (A full listing of technical reports appears at the end of this report.) This supplementary report, which is based on data from the same sources, focuses specifically on channeling's impacts in the 10 individual channeling sites. We assume that the reader is familiar with the research methodology and overall impact results presented in the other reports, so limit our discussion here to the site-specific results.
Differences in impacts by site have been examined in the separate technical reports to aid in the interpretation of results for specific outcomes; that is, to determine whether impacts at the model level are due to large treatment/control differences in only one or two sites, or are present in most or all sites or, alternatively, whether a lack of impacts at the model level is due to treatment/control differences at individual sites that are large in absolute magnitude but of opposite signs.