Reports

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.

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.

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.

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.

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.

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.

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:

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

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.

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.

Evidence Gap Map: Research Report and Overview

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.

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.

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.

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.

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

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.

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.

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 SurveyMethodological Description

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.

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.

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).

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 (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.

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.

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.

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.

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.

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.

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.

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.

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).

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.

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

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.

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.

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.

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.

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.

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.

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.

The Foundations for Evidenced-Based Policymaking Act of 2018 (Evidence Act) provided an important opportunity to Federal Agencies to assess and improve, where needed, their evaluation and other evidence building activities.

Despite the increasing evidence of high suicide rates and associated risk factors for older adults in the United States, the number of programs addressing these risk factors remains limited.

Direct care workers (DCWs) such as nursing assistants, home health aides, and personal care assistants play an essential role in the health and well-being of over 20 million Americans. Yet DCW wages are not enough to make jobs competitive with entry level positions in other industries with similar job requirements which exacerbates the challenges in recruitment and retention of these workers.

Development of novel antimicrobials has slowed, and the preclinical and clinical pipeline is likely to be insufficient to support current and future patient needs.

Emergency departments (EDs) are key partners in filling the gap between people who need opioid use disorder (OUD) treatment and people who ultimately receive it.

The Inflation Reduction Act (IRA) authorizes the Secretary of the Department of Health and Human Services (HHS) to negotiate prices directly with participating manufacturers for selected drugs that are high expenditure, single source drugs without generic or biosimilar competition.

The market for antimicrobial (AM) drugs is unique in that it is associated with a positive externality (public health) as well as a negative externality (antimicrobial resistance, or AMR) (Mossialos, et al., 2010). AMR occurs when microbes change over time and no longer respond to available medicine.

It is well known that antimicrobial resistance (AMR) creates a substantial and ongoing public health and economic burden and understanding the size and nature of this burden is important for the ability to respond to the threat of AMR. However, estimating or projecting that burden within the U.S.