John Bauer, Steve Aos, Mason Burley, Noa Kay, Stephanie Lee, Matt Lemon, Megan Morris - May 2015

WSIPP’s Board of Directors authorized WSIPP to work on a joint project with the MacArthur Foundation and the Pew Charitable Trusts to extend WSIPP’s benefit-cost analysis to certain health care topics. An important goal is to determine whether there are strategies that can help states control Medicaid and other health care costs.

This report reviews evidence on five topics: “lifestyle” programs designed to prevent diabetes; behavioral interventions to reduce obesity; transitional care to prevent hospital readmissions; patient-centered medical homes to reduce health care costs; and programs to reduce avoidable emergency department visits.

Stephanie Lee, Steve Aos, Annie Pennucci - February 2015

For the last 20 years, the Washington State Institute for Public Policy (WSIPP) has conducted systematic evidence reviews and economic analysis on a variety of topics for the Washington State Legislature. Over time, we have improved and refined the methods we use to conduct this research.

When WSIPP undertakes an economic analysis at the direction of the legislature, we use a standardized set of procedures to collect and analyze research literature. We then apply consistent methods to translate the research findings to dollars and cents, asking, “What are the overall benefits and costs?” of each program or policy option. Finally, we use information about the uncertainty in the research findings and economic assumptions to compute the risk associated with each policy option.

The primary goal of this research is to provide the legislature with objective information about the long-term economic consequences of each program or policy option reviewed. In this report, we summarize our current findings.

John Bauer - January 2015

The Washington State Institute for Public Policy's (WSIPP) Board of Directors authorized WSIPP to work on a joint project with the MacArthur Foundation and the Pew Charitable Trusts to extend WSIPP’s benefit-cost analysis to certain health care topics. The Pew-MacArthur Results First Initiative identified diabetes prevention as an important health care issue for states. One important goal is to determine whether diabetes prevention policies can help states control Medicaid and other health care costs.

We reviewed credible research studies from the United States and elsewhere to determine whether lifestyle programs can achieve these results. We find that, on average, the programs have significant effects on diabetes incidence, weight loss, and certain risk factors for cardiovascular disease.

John Bauer, Mason Burley - January 2015

The Washington State Institute for Public Policy's (WSIPP) Board of Directors authorized WSIPP to work on a joint project with the MacArthur Foundation and the Pew Charitable Trusts to extend WSIPP’s benefit-cost analysis to certain health care topics. The “patient-centered medical home” (PCMH) was identified as an important health care topic for states.

This study reviews evidence on the effectiveness of patient-centered medical homes in reducing emergency department utilization, hospitalizations, and total medical costs.

John Bauer - January 2015

The Washington State Institute for Public Policy's (WSIPP) Board of Directors authorized WSIPP to work on a joint project with the MacArthur WSIPP’s Foundation and the Pew Charitable Trusts to extend WSIPP’s benefit-cost analysis to certain health care topics. The Pew-MacArthur Results First Initiative identified the goal of reducing hospital readmissions as an important health care challenge for states.

For this report, we reviewed the national and international evaluation literature to determine whether transitional care programs have been shown to reduce hospital readmissions. Components of transitional care include coaches, patient education, medication reconciliation, individualized discharge planning, enhanced provider communication, and patient follow-up after discharge.

Mason Burley, Amy Scott - January 2015

The 2014 Washington State legislature directed the Washington State Institute for Public Policy (WSIPP) to “complete a comprehensive assessment of the utilization and capacity needs of crisis mental health services” and provide “an update to statewide utilization and capacity figures for evaluation and treatment facilities, inpatient psychiatric beds, and regional support network-funded crisis facilities.” This assignment follows a 2011 WSIPP report that examined the impact of new provisions to Washington State’s involuntary treatment act on psychiatric bed utilization; to view the 2011 report, click here.

This report details the historical and current availability of psychiatric treatment beds.

Marna Miller, Danielle Fumia, Noa Kay - January 2015

The 2013 Washington State Legislature directed the Washington State Institute for Public Policy (WSIPP) to create, in consultation with the Department of Social and Health Services (DSHS), University of Washington Evidence-Based Practice Institute (EBPI), University of Washington Alcohol and Drug Abuse Institute (ADAI), and the Washington Institute for Mental Health Research and Training (WIMHRT), an inventory of evidence-based, research-based, and promising practices.

The initial inventory of interventions and policies in adult mental health and chemical dependency services was published in May 2014. To view the May 2014 results, click here.

While we were not directed by the legislature to update this inventory, a WSIPP Board-approved contract with the Pew-MacArthur Results First Initiative enabled WSIPP to review four additional programs and update the literature on supported housing for chronically homeless adults.

John Bauer, Noa Kay, Matt Lemon, Megan Morris - December 2014

WSIPP’s Board of Directors authorized WSIPP to work on a joint project with the MacArthur Foundation and the Pew Charitable Trusts to extend WSIPP’s benefit-cost analysis to certain health care topics. An important goal is to determine whether there are strategies that can help states control Medicaid and other health care costs.

This report reviews evidence on six topics: “lifestyle” programs designed to prevent diabetes; behavioral interventions to reduce obesity; smoking cessation during pregnancy; transitional care to prevent hospital readmissions; patient-centered medical homes; and programs to reduce avoidable emergency department visits.

Megan Morris, Annie Pennucci, Steve Aos, Elizabeth Drake, Danielle Fumia, Marna Miller, Catherine Nicolai, John Bauer - December 2014

The 2014 Washington State Legislature directed WSIPP to identify programs and policies that can decrease tobacco and e-cigarette use and yield the greatest return on investment. WSIPP employed its standard approach to reviewing research evidence and conducting benefit-cost analysis.

We identified 40 topics with research of sufficient rigor to allow us to draw conclusions about effectiveness. Of the 40, we found that 33 produce, on average, reductions in tobacco use. We identified a few programs that have undesirable effects on outcomes.

Our findings apply to tobacco prevention and cessation strategies. For e-cigarettes, unfortunately, we were unable to locate any rigorous evaluations that measure the impact of prevention strategies. In this report we summarize state regulations as of October 2014 related to e-cigarettes.

Elizabeth Drake, Danielle Fumia, Lijian He - December 2014

The 2014 Washington State Legislature directed the Washington State Institute for Public Policy to examine the Drug Offender Sentencing Alternative (DOSA) for offenders sentenced to residential treatment in the community.

Residential DOSA was created by the 2005 Legislature as an alternative to prison for offenders with substance abuse problems. When ordered by a court, an offender’s sentence is reduced in exchange for completing chemical dependency treatment.

When possible, WSIPP conducts benefit-cost analysis to understand the long-term impacts of policies. In addition to residential DOSA’s effect on recidivism, research indicates that crime is avoided through confinement, known as “incapacitation.” We cannot empirically estimate the extent to which a residential treatment facility itself incapacitates offenders. Thus, we are unable to determine the degree to which the benefits from the favorable recidivism reduction of residential DOSA would be offset by the increased costs of non-confinement.