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The Long COVID Dilemma

The Long COVID Dilemma

by | Jul 18, 2023 | Econometrica Blog

The Long COVID Dilemma

SARS-CoV-2 Infection (COVID-19)

In 2022, SARS-CoV-2 infection (COVID-19) was listed as an underlying or contributing cause of 244,986 (61.3 per 100,000) deaths in the United States.1Beyond the acute-phase severity of the disease, we have learned that symptoms can linger or recur over months or years, resulting in ongoing disability: the Kaiser Family Foundation reports that the “percentage of people who have had COVID and currently report long COVID symptoms declined from 19% in June 2022 to 11% in January 2023. Despite the decline, the rate of long COVID among people who have had COVID remains high.”2 For some groups, the numbers are even higher.3

Whole-Person Care with an Equity Focus

The long COVID journey can be protracted and especially difficult for persons with fewer healthcare resources. Important whole-person supports include non-medical factors such as access to transportation to get to healthcare appointments, as well as access to nutritious food, a safe home environment, educational opportunities, and financial resources. These can all impact health and well-being during the recovery period.

Trauma-Informed Care

Families and caregivers were traumatized as well. Implementing the principles of trauma-informed care: safety, choice, collaboration, trustworthiness and empowerment,4 can be reassuring to patients and caregivers living in fear of reinfection or relapse. The experience of contracting the virus was terrifying for many, whether or not the disease led to hospitalization. And for those who suffered long hospitalizations with respirator care, contracting COVID-19 was an especially traumatic event.

At Econometrica, our experts work extensively with Federal agencies, subject matter experts, and stakeholders to shape services that are inclusive for all persons’ healthcare needs. We understand that chronic disorders can carry a heavy burden for underserved communities, and we coordinate with agencies and funders to look for ways to support persons with elevated needs.

Resources

1 Ahmad FB, Cisewski JA, Xu J, Anderson RN. COVID-19 Mortality Update — United States, 2022. MMWR Morb Mortal Wkly Rep 2023;72:493–496. DOI: http://dx.doi.org/10.15585/mmwr.mm7218a4 https://www.cdc.gov/mmwr/volumes/72/wr/mm7218a4.htm

2 Kaiser Family Foundation. Long Covid: What do the latest data show? January 26, 2023. https://www.kff.org/policy-watch/long-covid-what-do-latest-datashow/#:~:text=As%20of%20January%2016%2C%202023%2C%2015%25%20of%20all%20adults,are%20no%20longer%20reporting%20symptoms.

3 Goldie PD, Chatterjee I. Examining the elevated risk of COVID-19 in transgender communities with an intersectional lens. SN Soc Sci. 2021;1(10):249. doi: 10.1007/s43545-021-00255-x. Epub 2021 Oct 6. PMID: 34693307; PMCID: PMC8492083. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8492083/

4 University of Buffalo, Buffalo Center for Social Research. What is Trauma-Informed Care? https://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informedcare.html#:~:text=The%20Five%20Guiding%20Principles%20are,to%20providing%20Trauma%2DInformed%20Care

ECONOMETRICA BLOG

World Environment Day: Climate Change Implications for Human Health

by | Jun 2, 2023 | Econometrica Blog

World Environment Day earth and copy

Since June 5, 1973, the United Nations (UN) Environment Programme’s World Environment Day has provided a global platform for motivating research and action for a livable planet. According to the UN, “Climate change is the single biggest health threat facing humanity. The impacts are already harming health through air pollution, disease, extreme weather events, forced displacement, food insecurity and pressures on mental health. Every year, environmental factors take the lives of around 13 million people.”1

Environmental Factors

The environmental factors driving climate change arise from both naturally occurring changes as well as human activities, such as the release of carbon dioxide into the atmosphere. Regardless of the causes, however, the damaging effects of these changes are unequally distributed among the world’s population. Persons sensitive to heat because of age or illness and who cannot afford air-conditioned housing are at greater risk of adverse health effects from a warming planet, for example, while those living in increasingly flood-prone areas or who lack access to clean water may be disproportionately affected by water-borne illnesses.

Complex Systems

Local, regional, and national health systems are key to responding to these threats, but they are only one part of a complex system for promoting health. We are also beginning to understand how social determinants of health like housing, employment, education, and geography can significantly shape the health of populations. Researchers have begun to build a body of knowledge related to these determinants and to examine their effects in persons affected by climate change, and we can also use mapping and data analysis to look at specific instances of climatic effects on population health.

Resource Inequity

Reducing the health effects of climate change will require us to develop a solid understanding of three inter-related factors:

    • Direct effects of climate conditions on health, such as an increase in vector-borne diseases as temperature rise.
    • Underlying inequities in preventing, diagnosing, and treating health problems.
    • The distribution of available resources for improving the local, regional, and national environment and identification of areas with the greatest needs.

Econometrica’s Housing and Finance Group Is Looking at the Big Picture

In the past 2 years, Congress has passed two laws that provide hundreds of billions of dollars for new infrastructure projects. Together, the Inflation Reduction Act (IRA) and the Bipartisan Infrastructure Act (BIL) have funded more than 500 programs addressing important missions, including improving the with disaster and climate resilience of our Nation’s infrastructure, lowering carbon emissions, and providing cleaner air and water.

The challenge in such funding programs is to ensure that the money goes to the most important needs, not just the most aggressive grant applicants. Econometrica’s Economists and Data Analysts help agencies target their available funds in four ways.

  1. Data and analysis of needs. Although collecting data nationwide is expensive and requires specialized skills, it allows localities to fully understand their opportunities and saves the taxpayer money that would be wasted on ineffective projects.
  2. Program design. Early policy decisions are a powerful determinant of taxpayer return and environmental improvement, and one important policy driver is the method for spreading funds geographically. Econometrica provides optimization support for the main policy alternatives: formula allocations, competitive funding rounds, means tested programs, and disaster-based needs analysis.
  3. Agency outreach to communities. The neediest communities, and those with the greatest environmental challenges, are often those with the least ability to assess which of the 500+ programs they are even eligible for, let alone understand how to successfully navigate the application process. We build online eligibility screening systems and plain-language guidance materials to help these communities find and apply to the best programs for their needs.
  4. Program evaluation. This is the classic work of economists: cost–benefit analyses, market impact assessments, budget optimization, and the quantification of results. And it is the results that matter—finding the best social and environmental improvements for the fewest taxpayer dollars.

Work With Us, Contact Us

Need a partner in understanding the impact of climate change on the health of a population, or to help gauge the resources devoted to mitigating climate injustice? Our experts are here to help you. For a quick, direct response, visit us online and email a member of our executive staff in your preferred specialty.

Resources

https://www.worldenvironmentday.global/
https://www.un.org/en/climatechange/science/key-findings

1 https://www.un.org/en/climatechange/science/key-findings#health

ECONOMETRICA BLOG
How Microlearning With Explainer Videos Can Work for You

How Microlearning With Explainer Videos Can Work for You

by | May 2, 2023 | Econometrica Blog

Devices graphics

Learning solutions run the gamut from e-learning courses, to webinars, to tip sheets. But if you need to teach a brief concept, animated explainer videos make key pieces of information easy to access and a breeze to understand. The Learning Solutions Team at Econometrica uses this form of microlearning — breaking training down into small, more manageable bits of information — to support clients in government and industry.

Think of microlearning modules like chapters in a manual. An animated explainer video is like an illustration highlighting an important concept on one of the chapter pages, but more interesting. It uses audio and visual animation to get the point across.

Benefits of Using Animated Explainer Videos for Microlearning

Animated explainer videos are a good choice when people are having difficulty grasping a single concept, such as which medical code to select or how to use a new feature for an online dashboard. Animated explainer videos are:

    • Concise: They convey training on a single topic in a few minutes. Viewers can find the answer quickly without sifting through information they do not need.
    • Efficient: They support workflow learning, allowing users to train while they continue to be productive. Videos can be accessed from computers and mobile devices.
    • Engaging: Animated avatars and colorful visuals combined with limited text make explainer videos easy to watch and understand.

“Workflow learning is something people can access as they are doing their job. Animated explainer videos allow people to view the information at the moment they need it. They’re pulling the information they need, instead of having a bunch of other information pushed at them — which is far more efficient than traditional coursework,” says Sarah Gillam, M.Ed., senior instructional designer at Econometrica.

“In the healthcare setting, it is imperative to reduce what is called ‘provider burden.’ Animated explainer videos can help by reducing the amount of time providers must invest in training — time better spent on patient care,” adds David Westbrook, M.Ed., also part of Econometrica’s instructional design team.

Customizing Learning Solutions

Beginning in 2015, Econometrica was tasked by the Centers for Medicare & Medicaid Services (CMS) to develop training for providers and stakeholders related to the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. For the Post-Acute Care (PAC) Training project, we assessed training needs and created materials for 34,000 providers across the United States. So far, we have created approximately:

    • 29 live training events (in-person and virtual)
    • 52 webinars
    • 55 web-based trainings
    • 54 video tutorials and explainer videos
    • 136 job aids, including tip sheets, pocket guides, and cue cards

Based on provider feedback and assessment of training outcomes, we concluded that health providers would benefit from scenario-based examples. These examples work to strengthen their understanding of new and revised guidance that was addressed during prior trainings.

 Additionally, our goal is to be sensitive to providers’ time when developing training assets. In order to limit provider burden and provide additional training opportunities, we developed a four-minute animated explainer video. The videoreinforces how to correctly code Transfer of Health items at discharge. It was posted on YouTube in March and received more than 3,000 views in the first two weeks.

“The video is one of a series of videos we’re developing to target specific questions that providers have,” says Ms. Gillam. “The best part of all is that providers don’t need to watch all the videos in the series. They can simply search for the one that answers their question.”

Leaders in Instructional Design: Work With Us, Work for Us

Econometrica has more than 10 years of experience designing and implementing creative learning solutions on the national level like the PAC Training. Our team of the best and brightest in data science, health, grants management, energy, homeland security, housing and community development, capital markets and finance, and transportation, collaborates to develop customized training solutions that are accurate and effective. We can work as the lead service provider or as an outsource partner to other consultancies. For exceptional results on your next project, visit us online and e-mail our learning solutions team at LearningSolutions@econometricainc.com. To explore the benefits of working for us, visit our careers page.

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Housing Costs Rising? Learn When to Appeal a HUD FMR

Housing Costs Rising? Learn When to Appeal a HUD FMR

by | Apr 28, 2023 | Econometrica Blog

Fair market rent graphic

The U.S. Department of Housing and Urban Development (HUD) estimates fair market rent (FMR) for almost 2,600 areas nationwide as a basis for rent subsidy programs. When a HUD FMR fails to meet the housing needs of income-qualified residents in a community, it may be time to appeal by commissioning an FMR survey.

According to the government, a HUD FMR represents the cost to rent a moderately-priced dwelling in the local housing market. FMRs are typically determined by a predictive algorithm using data from the U.S. Census Bureau’s annual American Community Survey. When the cost of housing spikes, like it has the last few years, it can outpace the federal funding prediction methodology and the annual budgets for FMR-based subsidies.

 As a result, rent subsidy payments required to be based on the FMR can fall short, leaving a gap between the maximum subsidies allowed and the actual cost of renting an adequately sized, decent, safe, and sanitary dwelling. Inadequate subsidies can lead to fewer housing choices, affect the quality of housing people can afford, and lead to fewer vouchers available for those in need.

How Do You Know When the Rental Market Is Outpacing Your FMR?

If you are a housing authority or other community-based housing organization that distributes federal housing subsidies, such as Housing Choice Vouchers, it is important to know how to request that HUD reevaluate (increase) your annual FMR. The following are key indicators that the market is far out-pacing the current HUD FMR for your area and bringing hardship to your program participants:

    • Extended housing searches or returned vouchers: Subsidy recipients take longer than the typical 90 days to find housing or even have to turn their vouchers back in, because the pool of available and affordable rental properties narrows.
    • Fewer homes to choose from: The number of landlords accepting vouchers for rental properties, based on the payment standard, decreases because landlords cannot operate their property at payment standard rents or they can easily fill their property at higher rents.
    • Housing authorities are spending more per person: Providers are having to set voucher payments that push the upper threshold of what HUD allows (110% to 120% of FMR) in order to help people find available rental properties.
    • People are spending more: Voucher recipients are requesting to use more than 30 percent of their income toward their rent, because the only rents they can find are above the payment standard. Thus, jeopardizing their families financial stability and/or leaving less money for other necessities.
    • Waitlists are growing: If waitlists are open, which is often not the case due to the extreme demand for rental subsidies throughout much of the country, then they are growing longer as more people find themselves income qualified or spending more than 50 percent of income toward rent.

How to Find an FMR Survey Firm

To effect change, it is vital to conduct a successful FMR survey. HUD allows any FMR area housing authority to request a reevaluation of its FMR. In order to do so, the PHA must submit a valid data sample collected based upon HUD’s requirements with at least 100 qualified responses for areas with rental populations under 50,000 and at least 200 for those over 50,000. Generally speaking, at least 15,000 to 25,000 surveys are required in order to obtain 100 to 200 qualified responses. Accurate FMRs help families find and afford housing in areas of greater opportunity for safety, education, employment, and transportation. Who you select to complete the survey is also important. Look for a consultant to perform the FMR survey who has:

    • Deep expertise: Frederick Eggers, former chief economist and deputy assistant secretary for Economic Affairs at HUD, established Econometrica’s FMR survey program.
    • Customer service: Econometrica is dedicated to increasing housing opportunities for underserved populations and as a result is ready to work with communities where they are, helping them partner to work around budget issues or change methods to adjust to calendar constraints or a host of other techniques to meet the community’s ultimate goal.
    • Customized solutions: Our specialists have designed and implemented successful FMR surveys for urban, suburban, and rural communities, ranging from New York City to Transylvania County, North Carolina.
    • Demonstrated success: We completed half of all successful FMR reevaluations in the nation in 2022, achieving as much as a 24 percent increase in FMRs in one locality. 

Fair Market Rent Surveys for Large and Small Communities

The Housing Authority of the City of Asheville (HACA) in North Carolina recently had two successful FMR appeals based on FMR survey data and reports completed by Econometrica. In 2018, HACA noted that rents in the community were fluctuating from year to year. HACA clients were finding it more difficult to find affordable housing in neighborhoods of greater opportunity. HACA engaged Econometrica to perform an FMR survey. As a result, HUD increased 2020 FMRs by 21 percent. Asheville’s rental market boom continued, and HACA engaged Econometrica for a second FMR survey in 2021. This time, Econometrica’s report resulted in a 16.6 percent increase in HUD’s 2022 FMRs for HACA.

In addition, Econometrica was able to piggyback Asheville’s most recent FMR appeal with one for a rural neighboring community that failed to obtain a successful solo appeal in the past. With a small population in general and few renters, it was difficult for Transylvania County to garner a sufficient sample size to meet HUD survey requirements. Econometrica worked with HUD and the involved PHAs to determine ways to combine rural communities like Transylvania County with FMR surveys for more populated metropolitan areas. Consequently, HUD granted Transylvania County a 19.5 percent increase in FMRs for 2022 based on our survey completed in combination with Asheville in 2021. 

HUD FMR Surveys: Work With Us, Work for Us

Econometrica has 6 years of experience conducting FMR surveys and developing reports that lead to successful HUD appeals. Our team of the best and brightest in housing and community development, data science, and survey distribution collaborates to develop FMR surveys to meet the needs of your community, no matter the size. To learn more about Econometrica’s FMR survey process, contact us at HUDFMR@econometricainc.com. We will run a quick analysis to determine whether a local FMR survey makes sense for you and your community and guide you through the next steps.

If you are a specialist in housing and community development and want to expand your career, explore the benefits of working for Econometrica by visiting our careers page.

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Econometrica’s Data Scientists Use AI to Customize Research

Econometrica’s Data Scientists Use AI to Customize Research

by | Apr 4, 2023 | Econometrica Blog

Data science graphic
As a business management consultant firm, we understand the power of data science to evaluate and inform by collecting and examining information across a multitude of analytical platforms. Modern data science enables our researchers to dig deeper and uncover critical truths in a wide variety of projects for the government and private sectors.
We recently added narrow-based language models of artificial intelligence (AI) to Econometrica’s technical capabilities. AI allows us to bring a fresh perspective and highly customized results to our clients and partners in health, housing, communications, finance, homeland security, maritime and water resources, energy, and grants management.

Two key benefits differentiate narrow-based language AI from its predecessors:
    • Upgraded search capabilities: Our data scientists can search and organize large amounts of data more quickly and efficiently.
    • Highly detailed customization: The AI learns concepts based on words with similar uses, including synonyms, abbreviations, and common misspellings to produce more robust search results.

“Machine learning is newer in the areas we typically work. There are not many people in the world who know how to build narrow-based language models,” says Douglas Schuweiler, a data scientist in Econometrica’s Data Analytics Group. A specialist in behavioral neuroscience, Dr. Schuweiler studied how the brain learns by building artificial neural network models while earning his Ph.D. at Illinois State University.

“Using this newer level of artificial intelligence, we can build a model that is tailored to each client and focused on the data that needs to be analyzed,” says Dr. Schuweiler.

Data Science in Action: Program Evaluation

Recently, Econometrica was tasked by the Federal Emergency Management Agency (FEMA) with evaluating a nationwide grant program for disaster preparedness. In other words, were the projects generating the intended outcomes? We had to determine the effectiveness of 100,000 individual grant projects, but there was a great deal of latitude in the outcomes each project could achieve.

We used narrow-based language AI to analyze the project descriptions written by grant recipients. “It allowed us to form a more precise evaluation by matching the grant programs with their targeted outcomes,” says Dr. Schuweiler.

This summary of the FEMA project is simplified, but completing this task takes a significant time commitment from specialists with high-level expertise. Before comparing grant project descriptions to their intended outcomes, our team had to develop another model to differentiate project descriptions with a high level of detail from project descriptions with a low level of detail. The process took more than 6 months.

Data science is the linchpin in many of Econometrica’s projects. We use data analytics in statistical sampling, machine learning, data scrubbing, economic modeling, and analysis support for audits, regulatory work, improper payments, and predictive analytics. This support includes the following:

    • Development of detailed sampling plans.
    • Advanced statistical analysis of the results.
    • Comprehensive reports that document the methodologies used and certify the statistical validity of the analysis.

One recent data science project earned an Award for Excellence for our Data Analytics Group, based on the real-world impact it created. You can read about it here.

Work With Us, Work for Us

Econometrica specializes in data analytics for the public and private sector. Our team represents the best and brightest in data science, health, grants management, energy, homeland security, housing and community development, capital markets and finance, and transportation. We work as the lead service provider, and also as an outsource partner to other consultancies. For exceptional results on your next project, visit us online and email a member of our executive staff in your preferred specialty. To explore the benefits of working for us, visit our careers page.

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Econometrica’s Experience and Capabilities Related to Serving People With Disabilities

Econometrica’s Experience and Capabilities Related to Serving People With Disabilities

by | Mar 21, 2023 | Econometrica Blog

Disabilities graphic

Projects Involving People With Disabilities

Econometrica’s subject matter experts and project staff have more than 80 years of combined experience working on projects related to chronic health conditions and disabilities.

Post-Acute Care (PAC) Training, Centers for Medicare & Medicaid Services (CMS)

For over 7 years, Econometrica has developed and provided training to PAC providers on interviewing and assessing patients with regard to their disabilities and other medical conditions. PAC includes rehabilitation and palliative care for patients who have had treatment for a short-term medical condition, such as a severe injury, short-term illness, or surgery, and require continued medical care and assistance with daily living activities. We have created live in-person trainings and remote webinars, asynchronous e-learning courses, training videos, and associated job aids and documentation. We have trained more than 250,000 PAC medical providers across five care settings.

State Data Resource Center, CMS

By analyzing, organizing, and publishing Medicare data for States, Econometrica’s work on the State Data Resource Center project helped address care fragmentation issues for people who are dually eligible for Medicaid and Medicare. Econometrica conducted research, presented webinars, authored white papers, and developed a data portal to make these important data more accessible. People who are dually eligible for Medicaid and Medicare—including those who receive long-term care services and support for disabilities (49 percent of the dually eligible population) and those who have multiple chronic conditions (60 percent)—experience high rates of chronic illness.1 Econometrica’s work with Medicaid and Medicare data helped provide insight into the needs of people with disabilities.

Programs of All-Inclusive Care for the Elderly (PACE), CMS

PACE provides home- and community-based services for Medicaid and Medicare beneficiaries who want to stay at home and need a nursing home level of care to do so. PACE participants have multiple disabilities and need assistance with daily living activities such as dressing, bathing, transferring, toileting, eating, and walking. PACE participants have on average six chronic medical conditions, and 90 percent are dually eligible for both Medicaid and Medicare.2 Econometrica conducted 31 site visits to PACE organizations and interviewed PACE staff, caregivers, and participants to better understand the type of care received by PACE participants and how to systematically assess the quality of care delivered through the program. Our team conducted 15 technical expert panel meetings and hosted discussions with experts in the field to analyze existing quality measures and propose new ones, three of which are now endorsed by the National Quality Forum. Through this research, we learned more about the intricate needs of medically fragile Medicare and Medicaid beneficiaries, their family caregivers, and those who provide essential healthcare services to them.

2 National PACE Association. (2020, March). PACE by the numbers. Retrieved from https://www.npaonline.org/sites/default/files/images/infographic_images/ pace_infographic_update_side1_may2021.pdf.

 

Accessible Training

Econometrica has specific expertise in creating trainings that are fully accessible to all participants. We believe not just in fulfilling the basic obligations of Federal accessibility laws, but also in maintaining the spirit of those laws, making information access for people with disabilities as close as possible to the experience of those without disabilities. We have dedicated Learning Solutions and Section 508 Compliance teams that provide expertise, tools, and procedures from the beginning of each project to ensure accessibility prior to public release. Since we plan for accessibility from the start, we provide our clients with realistic expectations and avoid costly rework.
As more communication moves online, Econometrica excels in providing online training that is accessible to people with disabilities in both instructor-led live sessions and asynchronous, self-paced e-learning courses.

Instructor-Led Live Trainings In-Person Training

Econometrica ensures that the in-person trainings we conduct are accessible. We provide closed captioning during the event and ensure that all facilities are compliant with the Americans with Disabilities Act. Additionally, we simulcast our trainings so that those who have barriers to travel can participate online. We utilize technology that allows remote attendees to participate in any participant interactions, such as answering knowledge check questions, submitting questions to presenters, and evaluating the training.

Webinars

Econometrica designs and facilitates engaging webinars for audiences ranging in size from more than 1,000 to 35. Our webinars include both live captions during the presentation and edited captions in the recordings to ensure all acronyms and technical terms are correct for those with hearing disabilities. All supporting documentation, such as slide decks and job aids, are made Section 508 compliant prior to release.

Asynchronous E-Learning

Econometrica’s instructional designers make deliberate e-learning decisions with learners with disabilities in mind, such as minimizing the use of audio narration so as not to conflict with screen readers and including alternate text for figures and images. Econometrica develops courses using Articulate Rise, which has more built-in accessibility advantages than traditional, slide-based e-learning platforms:

    • The web-based platform allows updates to courses to be made and pushed live immediately, so learners with disabilities do not have to wait weeks for an accessible version of the updated information.
    • Content automatically adjusts to fit the screen of different devices (such as a computer, tablet, or phone), so learners with disabilities can use any device with their accessibility software.
    • Interactions that increase learner engagement, such as sorting, matching, and flashcards, are all Section 508 compliant in Articulate Rise and allow for keyboard navigation, unlike other platforms.

Econometrica has spent years understanding the needs of people with disabilities. We are passionate about inclusively designing communications and trainings for all. Please reach out to us to discuss how we can bring our expertise to your next contract or event.

Additional Resource

Disabilities Experience Capabilities PDF

Need experience and capabilities related to serving people with disabilities? Contact Us.

Our experts are here to help you. For a quick, direct response, visit us online and email a member of our executive staff in your preferred specialty.

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