WHEN HEALTH CHALLENGES THREATEN WORK, STATES EXPLORE SOLUTIONS

The following information was released by Mathematica Policy Research, Inc.:

Oct 16, 2025

Yonatan Ben-Shalom, Ankita Patnaik, and Kirsten Miller

Human Services Disability Employment and Training Economic Well Being and Income Support Federal State and Local Analytics and Operations Advanced Analytics

A health setback shouldn't mean the end of a career. But for millions of workers each year, that's exactly what happens. More than 3 million people leave the labor forceat least temporarilybecause of an injury, illness, or chronic condition. Without timely support, even a few weeks away from work can spiral into lost wages, job loss, and long-term insecurity.

Growing evidence shows it doesn't have to be that way. Early, targeted help can keep people connected to their jobs, reduce unnecessary turnover, and ease pressure on public benefit systems. Yet the workers who need this support mostoften mid-career employees who want to stay in the workforceare rarely prioritized in employment policy. Discussions often focus on young adults entering the labor market or people experiencing long-term unemployment.

Safety nets like short-term disability or workers' compensation are designed to fill the gap, but they don't always reliably reach the people who need them most. Many with unstable jobs or limited benefits find themselves navigating recovery and job loss alone.

Research shows that reaching workers earlybefore they fully disconnect from their jobscan make a measurable difference. Implementing programs that quickly provide tailored support can help workers weather a health crisis without losing the stability and purpose that meaningful work can provide.

State solutions show early promise

When workers experience a new disability or health setback, challenges span healthcare, employment, and insurance systems. States are uniquely positioned to align these systems and test multisystem solutions that aim to help workers stay employed.

Across the country, states are piloting strategies such as rapid outreach after a health event, communication with doctors and employers, and tracking workers' recovery and employment progress. Washington State's Centers of Occupational Health and Education demonstrates how coordinated approaches can keep workers on the job while reducing medical and disability costs.

Another major effort, the Retaining Employment and Talent After Injury/Illness Network (RETAIN), jointly led by the U.S. Department of Labor and Social Security Administration, is being testedin five states. RETAIN programs connect health care providers, employers, and workforce systems to create smoother pathways back to work through coordinated actions like clinician return-to-work guidance and employer job modifications.

Evidence from RETAIN is emerging, but earlier researchsuch as a Mathematica policy action paper for the Stay-at-Work/Return-to-Work Policy Collaborativehighlights some promising and practical levers: using short-term disability claims or provider referrals to trigger early outreach, case coordination, and employer incentives for accommodations.

Lessons for action

Insights from state pilots, private-sector initiatives, and policy evaluations point to several evidence-based strategies for improving employment outcomes after a health event:

Act early. The sooner outreach and support begin, the higher the chances of job retention.

Coordinate across programs. Seamless entry points reduce friction for workers and duplication across programs.

Keep it simple and practical. Supports such as workplace accommodations and transportation assistance can mean the difference between continuity and costly disruption.

Use data wisely. Data integration and analytics help focus resources on areas where they'll have the greatest impact.

The RETAIN demonstration is underway in five states, and Mathematica is leading its national evaluation. Look for us at upcoming presentations at the APPAM and ASSA conferences and watch your email for an invitation to an early 2026 webinar where we'll share evaluation findings.

Data-driven approaches to workforce stability

Mathematica is testing how predictive analytics and machine learning can identify workers most likely to benefit from employment retention programs. These approaches aim not just to keep people employed, but to build systems that respond quickly, operate efficiently, and help workers stay engaged and productive.

At Mathematica, our policy experts, data scientists, and technologists partner with federal and state agencies to design, evaluate, and scale efforts that help people stay in the workforceby making supports more timely, practical, and tailored to real needs.

Connect with us to learn how evidence-driven solutions can strengthen your workforce and keep talent where it belongson the job.