The Accelerated Benefits Demonstration project will provide health benefits and employment supports to certain newly entitled Social Security Disability Insurance (SSDI) beneficiaries. Under current law most SSDI beneficiaries must wait 24 months after cash benefits begin before they become eligible for Medicare. Thus, many people have no health insurance and therefore, have limited access to medical care during a period of time when access to those resources might serve to help improve their medical condition and thereby increase their ability to improve their self-sufficiency through employment.

What States/Locations are involved?

Phase I (October 2007) – New York City area, Phoenix, Minneapolis, Houston Phase II – In March 2008, enrollments began in the following locations. We will complete enrollments in January 2009.

 Atlanta, GA

Austin-San Marcos, TX

Baltimore, MD

Birmingham, AL

Boston, MA-NH

Buffalo-Niagara Falls, NY

Charlotte-Gastonia-Rock Hill, NC-SC

Chicago, IL

Cincinnati, OH-KY-IN

Cleveland-Lorain-Elyria, OH

Columbus, OH

Dallas, TX

Denver, CO

Detroit, MI

Fort Lauderdale, FL

Fort Worth-Arlington, TX

Grand Rapids-Muskegon-Holland, MI

Greensboro-Winston Salem-High Point, NC

Hartford, CT

Houston, TX

Indianapolis, IN

Jacksonville, FL

Kansas City, MO-KS

Las Vegas, NV-AZ

Los Angeles-Long Beach, CA

Louisville, KY-IN

Miami, FL

Milwaukee-Waukesha, WI

Minneapolis-St. Paul, MN-WI

Nassau-Suffolk, NY

Newark, NJ

New Orleans, LA

New York, NY

Norfolk-Virginia Beach-Newport News, VA-NC

Oakland, CA

Oklahoma City, OK

Orange County, CA

Orlando, FL

Philadelphia, PA

Phoenix, AZ

Pittsburgh, PA

Portland-Vancouver, OR-WA

Providence-Fall River-Warwick, RI-MA

Richmond-Petersburg, VA

Riverside-San Bernardino, CA

Rochester, NY

Sacramento, CA

San Antonio, TX

San Diego, CA

St. Louis, MO-IL

Seattle-Bellevue-Everett, WA

Tampa-St. Petersburg-Clearwater, FL

Washington, DC-MD-VA-WV


How does it work?

On January 20, 2006, the research organization MDRC was awarded the contract to implement and evaluate the Accelerated Benefits demonstration. Subcontractors include: Mathematica Policy Research (MPR), POMCO, CareGuide and TransCen, Inc.

Beneficiaries selected for the demonstration project were randomly assigned to one of three groups. All received their regularly SSDI cash benefits with no change in program rules. In addition, one group was provided health benefits, a second group was provided health benefits and received support under a care management model and employment/benefits counseling, and a third group was a control group that will be used as comparison to see if the intervention results in a difference health and employment outcomes. The target population was newly entitled SSDI beneficiaries, under age 55 with at least 18 months before entitlement to Medicare.

SSA's Expectations?

This research was designed to test whether short term investment in health care for newly entitled SSDI beneficiaries might have long term pay-offs, in terms of improving their medical conditions and increasing the likelihood that they will return to work. The project will help SSA determine the costs and benefits associated with providing immediate medical benefits to these individuals.

Early Findings

The full report prepared by our contractor can be found at: Accelerated Benefits final report at AB Final Report.  We have also posted an appendix to the report at AB Final Report-Appendices.
Some of the findings from the report show:

  • Participants made extensive use of program services. Almost all members of the AB and AB Plus groups used AB health benefits during the first year, most commonly for doctor visits, diagnostic testing, and prescription medications. Program group members averaged $19,265 in AB health benefit claims during the year. About 12 percent of program group members had AB health plan expenditures of $50,000 or more during the first year, representing 53 percent of the total health plan expenditures. Approximately 4.6 percent of program group members reached the $100,000 limit on expenditures within the first year.
  • AB health care benefits increased health care use and reduced reported unmet medical needs. In addition, members of the AB and AB Plus groups reported spending less of their own money on health care. There were few differences in these outcomes between the AB and AB Plus groups, suggesting that AB’s health care benefits were responsible for these improvements.
  • AB Plus services encouraged people to look for work but did not increase employment levels in the first year. Members of the AB Plus group were more likely to use vocational rehabilitation and other job preparation services and were more likely to look for work than either the AB group or the control group. Despite this promising intermediate result, the three groups had similar employment rates in the first year.
  • AB reduced participant difficulties by paying for necessities. Both the AB and AB Plus groups were less likely than the control group to skip or cut the size of meals, have trouble paying for rent or a mortgage, or have their phone service discontinued. This might be a consequence of their reduced out-of-pocket costs for health care.
These results are promising, but they reflect short-term impacts partway through the intervention. We will continue to track outcomes to assess whether long-term employment gains and reduced need for health care result in future savings for the federal government.