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Reports

Displaying 1 - 50 of 4251

Marketplace Enrollee Demographics, Plan Generosity, and Plan Premiums in HealthCare.gov States, 2015-2022

This Issue Brief focuses on the changes over time in Marketplace insurance coverage in HealthCare.gov states and the association between various demographic and plan characteristics including income, metal level selection, race and ethnicity, and premiums by leveraging self-reported and imputed data.

2025 HHS Evaluation Plan

The FY 2025 HHS Evaluation Plan details the Department of Health and Human Services’ (HHS) efforts to answer the priority questions presented in the current HHS Evidence Building Plan. This plan provides both an overview of HHS evaluation activities planned for FY 2025 and detailed information for each new and continuing evaluation effort.

Generic Drug Utilization and Spending Among Medicare Part D Enrollees in 2022

In 2022, 43.3 million Medicare Part D enrollees (82 percent) filled 1.1 billion prescriptions for generic prescription drugs. While most enrollees filled at least one prescription for $2 or less, most (54 percent) paid more than $2 for at least one generic drug. Over 6 million enrollees filled at least one prescription for over $20.

Inflation Reduction Act Research Series: Projected Impacts for Rural Medicare Enrollees

The Inflation Reduction Act (IRA) is helping people with Medicare, including over 8 million Part D enrollees who reside in rural areas. This fact sheet outlines the potential impacts of the IRA’s key drug-related provisions for rural Medicare enrollees.

National Uninsured Rate Remains Largely Unchanged at 7.7 Percent in the Third Quarter of 2023

According to the most recent National Health Interview Survey data, the national uninsured rate in the third quarter of 2023 was 7.7 percent, unchanged statistically from the first two quarters of 2023.

The Fiscal Impact of Refugees and Asylees at the Federal, State, and Local Levels from 2005-2019

Between 1990 and 2022, the United States welcomed over 2.1 million refugees and accepted over 800,000 asylees. While the purpose of granting visas to refugees and asylees is humanitarian, they do impact the United States economically. This analysis estimates the fiscal impact of refugees and asylees on federal, state, and local governments from 2005 to 2019.

Children’s Interagency Coordinating Council FY 2023 Report to Congress

As part of the Consolidated Appropriations Act, 2023, Congress provided HHS with funding for the Children’s Interagency Coordinating Council (CICC). The CICC is charged with fostering greater coordination and transparency on child policy across federal agencies and examining a broad array of cross-cutting issues affecting child poverty and child well-being.

Premarket Notifications and Patents for Breast Pumps Before and After the ACA

This study investigated whether ACA policies to increase access to breast pumps and lactation care were associated with innovation in the market for breast pumps.

Final Report: Child and Caregiver Outcomes Using Linked Data

Child maltreatment and involvement in child welfare systems are well-known adverse childhood experiences associated with poor health outcomes during childhood and later in life. Very little is known about the health needs of, and services used by families involved in child welfare systems, particularly those services funded by Medicaid.

Comparing Prescription Drugs in the U.S. and Other Countries: Prices and Availability

ASPE contracted with RAND Health Care to carry out three studies analyzing data on U.S. prescription drug prices and availability in comparison to drug prices and availability in other Organisation for Economic Co-operation and Development (OECD) countries. In 2022, U.S. prices across all drugs (brands and generics) were nearly 2.78 times as high as prices in the comparison countries. U.S.

Medicare Enrollees and the Part D Drug Benefit: Improving Financial Protection through the Low-Income Subsidy

The Inflation Reduction Act’s (IRA) expanded financial assistance in Medicare’s Low-Income Subsidy (LIS) Program would have benefited nearly 461,000 Partial LIS enrollees had the provision been in effect in 2020. An additional 2.9 million Part D enrollees who were eligible but not enrolled in LIS would also have benefited from the program.

HHS Standard Values for Regulatory Analysis

The U.S. Department of Health and Human Services (HHS) analyzes the benefits, costs, and other impacts of significant proposed and final rulemakings, consistent with the requirements of several executive orders and statutes. HHS develops these analyses according to technical guidance published by the U.S.

Child Care Workers’ Experience of Economic Hardship During the COVID-19 Pandemic, from 2021 to 2022

This brief shares findings from an analysis using U.S. Census Household Pulse Survey data to examine child care workers’ experience of economic hardship from 2021 to 2022 along different measures of economic hardship, across time, by race and ethnicity, and whether child care workers lived with young children. We find:

Child Support Engagement in Rural and Non-Rural Counties: More Engagement and Lower Amount Owed in Rural Areas

This brief describes differences in engagement in child support for custodial parents living in rural and nonrural areas. Key findings are below.Key Points:

State Efforts to Coordinate Provider Directory Accuracy

Provider directories are lists of in-network providers produced by health care plans. They are an important tool for individuals seeking health care providers, and for regulators who monitor the adequacy of health plans’ provider networks.

Claims and Provider Payment Data Gaps for Responding to COVID-19

This report and accompanying discussion by ASPE and NORC highlights the claims data limitations identified during the COVID-19 Public Health Emergency Health (PHE) and provides considerations to address these limitations. The report identifies that limitations related to claims data were existing issues, exacerbated by, but not unique to, the COVID-19 PHE.

Reconnecting Youth: Compendium of Programs

Compendium of Programs: Research Report and Overview The Reconnecting Youth compendium of programs provides an overview of 78 programs and the practices they employ to support young people who experience disconnection from school and work during their transition to adulthood.

Health Information Technology Adoption and Utilization in Long-Term and Post-Acute Care Settings

This paper provides an overview of Health Information Technology (HIT) adoption and utilization in long-term and post-acute care (LTPAC) settings. This study found that LTPAC have adopted electronic health records (EHRs) to support clinical and business needs. Interoperable exchange of health information however is not routine or widely used.

Inflation Reduction Act Research Series: Medicare Part B Inflation Rebates in 2023

The Inflation Reduction Act (IRA) includes provisions to increase accessibility and affordability of prescription drugs for the 65 million Medicare beneficiaries, reduce the rate of growth in Medicare drug spending, and improve the financial sustainability of the Medicare program. These IRA provisions include a rebate on certain Part B and D drug prices if prices rise faster than inflation.

National Plan to Address Alzheimer’s Disease: 2023 Update

Through the National Plan, HHS and its federal partners work to improve the trajectory of ADRD research, support people living with dementia and their caregivers, and encourage action to reduce risk factors. This page will soon provide the HTML version of the National Plan 2023 Update; the PDF is available now.

A Historical View of The Demographic and Employment Characteristics of Families Receiving Child Care Subsidies From 2009-2013

The child care subsidy program provides critical support to families to support parental labor force participation as well as child development. This study provides a historical view of the socioeconomic and demographic characteristics of parents who received subsidies over the 2009-2013 period.

Emerging Practices for Supporting LGBTQI+ Young People Across Human Services Programs

The Emerging Practices for Supporting LGBTQI+ Youth project highlights promising and emerging practices that human services agencies, programs, staff, and leaders are using to make human service delivery and prevention more welcoming and accessible for LGBTQI+ young people (ages 10-24) in child welfare and juvenile justice systems, as well as those experiencing homelessness, and those seeking s

Competition in Prescription Drug Markets, 2017-2022

The cornerstone of a well-functioning market is competition. President Biden’s Executive Order 14036, “Promoting Competition in the American Economy” identified a lack of competition as a key driver for problems across economic sectors.

Advancing Research on Intersections of Child Welfare and Medicaid Using Linked Data from the CCOULD Project

Increasing availability of linked child welfare and Medicaid data can advance research on the intersections of child welfare and Medicaid. The project, Child and Caregiver Outcomes Using Linked Data (CCOULD), developed a research-use dataset combining child welfare records and Medicaid claims for children and families involved in child welfare systems in Florida and Kentucky.

Project Update: Child Welfare and Health Infrastructure for Linking and Data Analysis of Resources, Effectiveness, and Needs (CHILDREN) Initiative

This brief describes progress in the Child Welfare and Health Infrastructure for Linking and Data Analysis of Resources, Effectiveness, and Needs (CHILDREN) Initiative, which is entering its second year. At this time, four jurisdictions have been selected for participation in the CHILDREN Initiative and are engaging in feasibility studies to determine readiness for linking data.

State and Local Estimates of the Uninsured Population in the U.S. Using the Census Bureau’s 2022 American Community Survey

State and Local Estimates of the Uninsured Population in the U.S. Using the Census Bureau’s 2022 American Community SurveyMethodological Description

Substance Use and SUDs by Race and Ethnicity

This brief assesses whether and how rates of substance use and substance use disorder (SUD) among adults (ages 18 and older) differ by race and ethnicity. The authors combine five years of data, 2015-2019, from the National Survey on Drug Use and Health (NSDUH) to create sample sizes large enough to examine specific racial and ethnic groups for specific categories of drug use.

HHS Call to Action: Addressing Health-Related Social Needs in Communities Across the Nation

The U.S. Department of Health and Human Services (HHS) envisions a future in which everyone, regardless of their social circumstances, has access to aligned health and social care systems that achieve equitable outcomes through high-quality, affordable, person-centered care. This Call to Action complements the companion U.S.

Community Care Hubs: A Promising Model for Health and Social Care Coordination

ASPE, in partnership with the Administration for Community Living, commissioned the RAND Corporation to better understand existing approaches to coordinating health and social care services through backbone organizations, with a focus on one particular model, community care hubs (Hubs).

Trends in Ownership Structures of U.S. Nursing Homes and the Relationship with Facility Traits and Quality of Care (2013-2022)

Stakeholders, researchers, and policymakers have identified varying nursing home ownership structures and ownership transactions as potentially influencing the quality of care delivered to vulnerable residents.

Contingency Management for the Treatment of Substance Use Disorders: Enhancing Access, Quality, and Program Integrity for an Evidence-Based Intervention

Contingency management (CM) is an evidence-based psychosocial therapy for the treatment of stimulant use disorder, as well as a variety of other substance use disorders (SUDs), that is supported by three decades of research. Despite CM’s great potential and demonstrated effectiveness in improving the health and well-being of many people with SUDs, this proven treatment remains underutilized.

National Uninsured Rate Remained Unchanged in the Second Quarter of 2023

According to the most recent National Health Interview Survey data, the national uninsured rate in the second quarter of 2023 was 7.2 percent, unchanged statistically from the first quarter of 2023.

Behavioral Health Diagnoses and Treatment Services for Children Involved with the Child Welfare System

This research brief uses claims data from the Medicaid and Children's Health Insurance Programs to examine the behavioral health diagnoses and treatment services received by children and youth involved with the child welfare system in 2019.

Early Childhood Workforce Data for Impact: Convening Brief and Data Snapshots

The Early Childhood Workforce Data project highlights exemplary state activities that drive data use to address early childhood workforce issues, including the national early childhood workforce shortage. A U.S.

State All Payer Claims Databases: Identifying Challenges and Opportunities for Conducting Patient-Centered Outcomes Research and Multi-State Studies

This report is the third in a series of reports commissioned by the Office of the Assistant Secretary for Planning and Evaluation (ASPE) from the RAND Corporation addressing state all payer claims databases (APCDs). APCDs include medical, pharmacy, and dental claims, as well as enrollment and provider files collected from private and public payers by states, usually as part of a State mandate.

Addressing Homelessness Among Older Adults

The number of older adults at risk of and currently experiencing homelessness has increased rapidly in recent years, a trend that is projected to continue and further accelerate. Older adults at risk of or experiencing homelessness have unique needs compared to other populations experiencing homelessness.

Reimbursement Mechanisms in Team-Based Behavioral Health Care

Team-based behavioral health care can effectively address clinical needs and mitigate behavioral health workforce shortages. Despite the demonstrated benefits of team-based care models, experts in the fields of behavioral health workforce and network adequacy have noted that existing reimbursement models do not adequately support team-based care.

Refugee and Asylee Data on the Utilization of Medicaid

This brief describes a joint project of the ASPE and the Office of Refugee Resettlement in the Administration for Children and Families to enhance the data infrastructure of agencies managing refugees and Medicaid services. This project is funded by the Patient-Centered Outcomes Research Trust Fund.

Linking State Medicaid Data and Birth Certificates For Maternal Health Research

This report presents the set of guiding principles for linking state Medicaid data with birth certificates that was developed by state and national experts and leaders. These guiding principles can be implemented to create a multistate linked database that researchers would be able to access and use for research on maternal health, including patient-centered outcomes research (PCOR).

Identifying and Classifying Medicaid Home and Community-Based Services Claims in the Transformed Medicaid Statistical Information System, 2016-2020 Issue Brief

Home and community-based services (HCBS) are a range of medical and non-medical services provided in the home and community that support individuals with functional limitations, enabling them to reside in the community rather than in institutional settings.

Reviewing, Refining, and Validating Claims-Based Algorithms of Frailty and Functional Impairment

This report describes validation of claims-based frailty algorithms for potential use in Medicare claims. Related Products:

EHR Implementation Guide – Identifying Frailty Using Existing Health Data: Challenges and Opportunities for Health Systems

RAND identified use cases on identifying frailty using electronic health record (EHR) data in health systems in the US and examples from other countries, which demonstrate applications in both primary and specialist care. The final EHR implementation guide summarizes the learnings from participants in the EHR Learning Network and the identified use cases.

Changes in the List Prices of Prescription Drugs, 2017-2023

Drug manufacturers may change the list prices of their drugs at any time after launch. Over the period from January 2022 to January 2023, more than 4,200 drug products had price increases, of which 46 percent were larger than the rate of inflation. The average drug price increase over the course of the period was 15.2 percent, which translates to $590 per drug product.

Surging the Public Health Workforce: Lessons Learned from the COVID-19 Response at State, Tribal, Local, and Territorial Public Health Agencies

The Office of the Assistant Secretary for Planning and Evaluation (ASPE) released a report summarizing lessons learned from surging the governmental public health workforce at state, tribal, local, and territorial (STLT) public health agencies during the COVID-19 pandemic.

Trustworthy Artificial Intelligence (TAI) for Patient-Centered Outcomes Research (PCOR)

The rise of artificial intelligence (AI) in health care and health care research has stimulated discussion on the application of trustworthy principles for AI. This report summarizes 15 considerations and 14 opportunities for the implementation of HHS’s trustworthy AI principles in patient-centered outcomes research projects that incorporate AI technology.

Inflation Reduction Act Research Series: Projected Impacts for Asian, Black, and Latino Medicare Enrollees

The Inflation Reduction Act (IRA) is helping people with Medicare afford their medications, including the 2.1 million Asian, 5.8 million Black, and 5.3 million Latino Part D enrollees. These fact sheets review existing research to present the projected impacts of key IRA Medicare drug-related provisions for these populations.

Understanding the Impacts of OS-PCORTF Projects on Data Capacity: An Interim Qualitative Assessment

This report presents findings from an interim qualitative assessment that examined the ways in which OS-PCORTF projects collectively advanced the ability of researchers to conduct patient-centered outcomes research (PCOR) by (1) improving the quality of data; (2) providing more relevant, comprehensive data; (3) enhancing analytical resources; and (4) reducing barriers to data access and use.

Medicaid HCBS State Policy Flexibilities During COVID

During the COVID-19 public health emergency, states used Appendix K, a standalone appendix available during emergency situations, to modify their existing Medicaid HCBS 1915(c) waiver programs. Using Appendix K, states can make to make temporary changes to access and eligibility, payment, services, and other aspects of their waiver programs.

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