Accelerated Benefits Demonstration

Prepared for
Social Security Administration
man in wheelchair with female friend

Will short-term investment in medical benefits for certain Social Security Disability Insurance (SSDI) beneficiaries have long-term payoffs? Specifically, will it improve their health and increase the likelihood they will return to work?

Extending a long tradition of being at the forefront of studying disability policy issues at the national level, Mathematica subcontracted with MDRC to evaluate the Accelerated Benefits Demonstration for the Social Security Administration (SSA). This demonstration tested the efficacy of providing immediate medical benefits to SSDI beneficiaries. Under current law, these beneficiaries must wait 24 months before becoming eligible for Medicare. During this time, a beneficiary's health may deteriorate for a number of reasons—including the natural progression of a medical condition, lack of access to medical care, and physical inactivity. Our team examined the effects of providing earlier access to health insurance coverage on several outcomes, including a beneficiary’s health, medical expenditures, employment, earnings, and continued participation in SSDI. The study included rigorous evaluation using random assignment, extensive process analysis to track project implementation and fidelity to program models, and cost-benefit analyses to help SSA decide whether to offer accelerated access to health insurance on a wider basis.

Mathematica provided technical assistance in developing the intervention. We also conducted a baseline interview to enroll participants in the demonstration and two follow-up interviews to measure changes in health and employment outcomes, as well as providing assistance in all aspects of the evaluation, including the impact, process, and cost-benefit analysis.