Policy and Management Guidance on Veterans Benefits
ICF Macro conducted a comprehensive study to help shape policy and
management practices at the Department of Veterans Affairs (VA)
regarding several need-based programs for eligible veterans, surviving
spouses and children, and parents. A pension program provides payments
to disabled veterans with low incomes and to surviving spouses and
children of deceased wartime veterans based on need. The VA also
makes payments to low-income parents of deceased service members
or veterans and to survivors of veterans who died from service-related
causes or who had a service-related disability.
To support decisions regarding the pension and survivors’
programs, ICF Macro conducted a comprehensive study of their effectiveness
and efficiency. The examination included a legislative and policy
assessment, an outcome assessment, a nonparticipation assessment,
an operational assessment, an analysis of program interrelationships,
and an assessment of future needs.
To carry out this work, we analyzed administrative data from the
VA. We conducted a telephone survey of more than 3,000
participants in the VA programs and held focus groups with nonparticipants.
We brought stakeholders together to identify needs and outcomes.
In addition to presenting a written report, we briefed VA officials
and Congressional staff on our findings and their implications for
policy.
Evaluation of the Federal Direct Student Loan Program
To assist policymakers with decisions about Federal loan programs,
ICF Macro compared the U.S. Department of Education’s Federal
Direct Student Loan Program (FDSLP) with an older program that relied
on private lenders to provide loan capital. To assess Federal cost
savings from direct lending, we used computer-based models that
projected and compared different types of loan life cycle costs
of the two loan programs. We interviewed senior project staff and
policymakers and reviewed records and documents on the administration
of both programs. We conducted case studies at FDSLP institutions
to learn about implementation. To gauge institutional satisfaction,
we conducted annual mail surveys of more than 3,000 institutions.
To measure borrower satisfaction, we administered computer-assisted
telephone interviews to thousands of borrowers. In addition to submitting
yearly reports, we disseminated our findings through briefings and
presentations throughout the 5-year study.
Programs and Policies to Prevent Childhood Obesity
ICF Macro coordinated an innovative process for the Robert Wood Johnson Foundation, the CDC Foundation, and the Centers for Disease Control and Prevention (CDC) to identify promising obesity prevention policies and programs. Through extensive environmental scans, we identified promising practices around the country with the potential for impact in obesity prevention. Using evaluability assessments (EAs) we led succinct reviews of initiatives’ plausibility and readiness for evaluation. We convened renowned experts in the field of healthy eating and active living and trained a cadre of more than 30 staff and other investigators to conduct EAs. From 458 nominations of potentially promising practices, we conducted approximately 50 EAs, identifying 20 promising policies and programs—six of high priority for evaluation—by the expert panel. These promising practices offer examples to other communities of strategies for tackling childhood obesity. A special journal issue of New Directions in Evaluation and a chapter in the Annual Review of Public Health (both forthcoming) will discuss the process and results of this project. Following on this foundational work, ICF Macro now is conducting the evaluation of New York City’s policy for daycare centers that provides nutrition standards, places limits on TV viewing, and prescribes the amount of time children are to spend in physical activity. The policy evaluation will help NYC to provide more effective nutrition and physical activity training and TA to its licensed daycare centers. Through the assessment of this and other policies and programs, ICF Macro is helping to begin the work of transitioning from practice-based evidence to evidence-based practice.
Ohio Family Health Survey
ICF Macro has conducted multiple surveys of family health for the Ohio Department of Job and Family Services (ODJFS) with adults and parents of children throughout the state to determine who does, and does not, have health insurance. ICF Macro developed the survey instrument, defined a complex sampling design, developed the training manual, and conducted over 50,000 interviews with strata by county, geographic region, and race/ethnicity. This research is critical to understanding health insurance coverage across Ohio. Findings from this survey are used to inform policy decisions regarding important issues such as Medicaid coverage, access to services including dental care and mental health care, and targets for health promotion efforts in the state.
Referral for Financial Gain, The Federation of State Boards of Physical Therapy (FSBPT)
ICF examined the potential linkage between the ownership status of physical therapy practices and utilization levels and cost of care. There is concern that physician ownership of physical therapy practices generates additional and unnecessary prescribing of physical therapy services and that this overuse may result in poorer outcomes. This study examined the literature on these issues to determine if there is evidence that (1) vertical ownership of services leads to over-prescribing of service and (2) intense use of physical therapy services can result in poor outcomes. Based on the findings of this initial examination, the study team determined what additional research was needed to inform this issue and developed a request for proposal, assessed the proposals, and assisted the FSBPT in securing a contract for further study.
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