Introduction
Research Questions
- What does the evidence say about case management interventions for people with low incomes?
- Do case management interventions increase earnings, employment, education or training, and do they reduce the receipt of public benefits?
- What are the most effective case management interventions?
Case management is a service delivery approach in which staff meet with clients to provide direct, personalized one-on-one support to improve a comprehensive set of outcomes related to employment, education, housing, health, and public benefit receipt. This Evidence Snapshot summarizes what rigorous research tells us about 21 interventions that used case management as their primary service and the interventions’ impacts on earnings, employment, the receipt of public benefits, and education and training. The data come from 27 high- or moderate-quality studies that began between 1987 and 2011, were published through May 2022, and were reviewed by the Pathways to Work Evidence Clearinghouse.
Purpose
This Evidence Snapshot describes the effectiveness of programs that were identified by the Pathways Clearinghouse as using case management as their primary service. It summarizes what we know about these programs and their impacts so Temporary Assistance for Needy Families (TANF) and other program administrators, policymakers, researchers, and the general public can apply the evidence to their context and the questions that matter to them.
Key Findings and Highlights
On average, case management interventions produced modest improvements on outcomes and had the largest effects on earnings. In particular, for intervention participants -- as compared with comparison groups that did not receive intervention services --
- Short-term annual earnings increased by $410, and long-term annual earnings increased by $490, on average, across 18 case management interventions for which effects on these outcomes could be calculated.
- On average, employment did not change in the short term, and long-term employment increased by 1 percentage point across 18 case management interventions for which effects on these outcomes could be calculated.
- The proportion of people receiving public benefits did not change in the short term and decreased by 1 percentage point in the long term, on average, across the 16 case management interventions for which this outcome was examined. The amount of annual public benefits received decreased by $167 in the short term and $120 in the long term, on average, across 12 case management interventions for which effects on this outcome could be calculated.
- Education and training attainment increased by 2 percentage points, on average, across the 6 case management interventions for which these outcomes were examined.
- Three case management interventions improved outcomes in two or more domains examined by the Pathways Clearinghouse.
Methods
The Pathways Clearinghouse assigned an effectiveness rating to each intervention in each of four outcome domains: earnings, employment, public benefit receipt, and education and training. The rating describes the extent of support that the intervention is likely to produce favorable results in that domain if faithfully replicated with a similar population.
For this snapshot, the Pathways Clearinghouse calculated the average impact for each domain by averaging impacts within moderate- and high-quality studies, then within interventions (because there may be multiple studies on a single intervention), and then across case management interventions. The average includes all studies, not just those with a supported rating or statistically significant findings, because these studies still provide useful evidence in considering the overall effectiveness of case management.
This snapshot describes the interventions using case management that had positive impacts on earnings, employment, public benefit receipt, and education and training, and highlights interventions that were effective in multiple outcome domains.
Citation
McCallum, Diana, Olivia Mirek, Irma Casteneda, and Erin Welch (2023). Evidence Snapshot: Case management, OPRE Report #2023-163, Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.
Glossary
- Case Management:
- Meeting, typically one-on-one, with an employment specialist or counselor who helps assess needs and refers clients to other available services. Case management can take place before or during employment and could focus on employment or on other topics, such as mental health or a substance use disorder.
- Primary service:
- An intervention’s primary service is the principal service of the intervention. The primary service is (1) a component that a large proportion of intervention group members received and a large proportion of comparison group members did not and (2) the component that was described by the study authors as most integral to the theory of change tested by the study. Interventions may provide multiple services, but only one service is designated as primary.