January 2020 North America Newsletter

Camden Coalition healthcare workers visit patients.
Photo: Camden Coalition

Good morning,

This month saw the release of results from the groundbreaking Camden Core Model randomized evaluation, which measured whether this care coordination program for patients with complex needs resulted in lower health care utilization. This study by Finkelstein et al. was one of the first we launched after starting J-PAL North America six years ago. From our first conversation with Dr. Jeffrey Brenner, I was impressed by his commitment to seeking evidence. As stated in the New York Times in 2014, “[Jeffrey] can’t really be sure his program works without testing it.”

This commitment to wanting rigorous evidence was all the more impressive because Dr. Brenner had already won a MacArthur fellowship award for this approach and was receiving requests across the country to scale it. No one was pressing him to do a randomized controlled trial (RCT) of the evaluation. 

I don't see the results of this RCT as inherently disappointing. Yes, it's hard to see that the intended outcome didn't happen, but learning that is useful. It gives us one more piece in the puzzle that we all need to solve urgently: how to best serve these patients. I am inspired by the Camden Coalition's leadership to pursue rigorous research, and I am excited to explore more opportunities to partner with innovative organizations to evaluate the impact of their programs.

Just this month, J-PAL North America is launching two opportunities for new partnerships. Our newly launched Housing Stability Evaluation Incubator is currently seeking partner organizations working to reduce homelessness and promote housing stability. I am also thrilled to announce that our State and Local Innovation Initiative will be developing a mobility from poverty learning agenda, in partnership with the Bill & Melinda Gates Foundation, to lay out key areas where new or additional research is best positioned. We are excited to see where these projects will take us and what policy lessons these new partnerships will generate.

Mary Ann Bates
Executive Director, J-PAL North America

Evaluation results of Camden Coalition care transition program inform the future of health care delivery and complex care

Breaking results from a randomized evaluation by researchers in J-PAL’s network and the Camden Coalition of Healthcare Providers provides important evidence for the field of health care delivery and care management. The study evaluated the impact of the Camden Core Model, which provides intensive, time-limited clinical and social assistance to individuals with complex needs who incur high health care costs. Researchers found no statistically significant impact on the rate of six-month hospital readmission, despite previous observational studies of similar interventions that suggested substantial reductions in readmissions. 

Amy Finkelstein, Co-Scientific Director of J-PAL North America and Principal Investigator of the study, describes in a STAT news op-ed how the evaluation results reveal challenges in reducing hospital readmission rates for a medically and socially complex patient population with very high health care utilization rates. She also underscores the importance of using randomized evaluations to measure the impact of such interventions in light of previous observational studies that found positive impacts from this approach. We also sat down with Amy and leaders of the Camden Coalition in a J-PAL blog post series to dive deeper into the research partnership and lessons learned. See in-depth coverage on the Camden Core Model in this Tradeoffs podcast, as well as coverage on the evaluation results in the New York Times, Politico, Bloomberg, and Reuters.

J-PAL North America launches housing stability evaluation incubator

J-PAL North America is seeking organizational partners to rigorously research strategies to reduce homelessness through our newly launched Housing Stability Evaluation Incubator. Organizations that operate programs or policies aimed at reducing homelessness and promoting housing stability are invited to apply for pro-bono technical assistance from J-PAL North America’s staff of policy and research experts to develop an evaluation idea, flexible funding, and connections with J-PAL’s network of leading academic researchers. If you know of organizations running programs aimed at fighting homelessness, please encourage them to submit a Letter of Interest by April 6, 2020. To receive updates related to the Housing Stability Evaluation Incubator, please sign up for J-PAL North America’s homelessness mailing list, or learn more about the application process by attending an informational webinar on February 10.

State and Local Innovation Initiative launches new mobility from poverty learning agenda

This winter, J-PAL North America's State and Local Innovation Initiative, with support from the Bill & Melinda Gates Foundation, will develop a mobility from poverty learning agenda to outline critical research questions facing state and local governments in the United States. J-PAL North America will leverage its existing state and local government partners and leading academic researchers to identify and synthesize the most pressing needs among policymakers on how to promote mobility from poverty and identify key opportunities for research to help address these needs. The learning agenda will be accompanied by a convening of state and local officials and a comprehensive media dissemination strategy to ensure the learning agenda leads to meaningful action.