Increased investment in research has helped the Department of Social and Health Services in Washington state better understand the links between untreated substance use disorders and other human services outcomes, such as housing stability, homelessness, and avoidable costs of emergency room visits. Starting in the 1990s, the department has built its capacity to gather data across a range of services to better analyze the impact of specific programs.
The department’s Research and Data Analysis (RDA) division now measures a range of outcomes by gathering and matching administrative data, such as information collected by government agencies to determine eligibility for programs, manage cases, and make payments. In the case of untreated substance use disorders, analysis of the matched data demonstrated that lack of access to appropriate services boosted both avoidable public expenditures and negative social outcomes.
Recognizing the value of linking multiple sources of existing data to perform these analyses, RDA developed an integrated system that imports and matches client information from over 20 different data systems. This effort provides a comprehensive, cross-agency view of client experiences and service information, such as the type, length, and costs of services received, residential and employment history, involvement in the criminal justice system, and demographic information. RDA then uses the data to regularly analyze the state’s social and health services, including evaluations of program impact.
For instance, RDA used the integrated system to help assess the impact on Medicaid costs of the state’s “Roads to Community Living” program, which helps those with long-term care needs transition from institutional to community-based care. The system allowed the division to create a comparison group that closely mirrored the program’s treatment group so analysts could better isolate the impact of this service, a process that would have been difficult without the extensive client data. The study found state and federal Medicaid savings of $21.5 million for the treatment group compared with nonparticipants over a two-year follow-up period.
To maintain the integrated system, RDA works with each agency that agrees to share data to extract and match client records. For most systems, this matching and linking occurs on a monthly basis to keep the database up to date. Data-sharing agreements ensure that each office maintains data ownership and establishes requirements for data security, privacy, and protection of personal information. The agreements also clarify how the information can be used, such as for evaluations. RDA staff provide ongoing quality control to identify duplicate records and data anomalies, and to ensure information is accurately linked and organized.
This system has helped to ensure:
RDA leaders attribute their success in developing and using these integrated data systems to:
RDA’s integrated system provides policymakers with a more complete picture of how residents use Washington’s public services and helps researchers more easily assess whether these programs improve human services outcomes.
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Sara Dube is a director and Darcy White is an officer with the Pew-MacArthur Results First Initiative.