Reports

In 2017, at least 2.8 million people in the U.S. acquired serious infections with bacteria that are resistant to one or more antimicrobial drugs and 35,000 have died as a result. Resistance to antimicrobials is viewed as a global threat with antimicrobial drug use in human and animal health driving resistance.

Introduction

As the United States population ages, a larger proportion of individuals will likely need and use long-term services and supports (LTSS). Much of this support is provided by informal (i.e., unpaid) caregivers. For those that need paid LTSS, most Americans pay out-of-pocket. Some may do so until their personal resources are exhausted, and then rely on the Medicaid safety net.

This report and dataset inventory identifies individual-level measures for conducting patient-centered outcomes research (PCOR) relevant to adults with disabilities, aged 18–64 years.

This project developed a calculator to help people anticipate how a change in earnings from employment would affect their net income, and in so doing, provide public benefit recipients with their estimated effective marginal tax rate on new earnings. Key Points:

To enhance transparency in health care markets, in December 2022, the Centers for Medicare & Medicaid Services (CMS) publicly released comprehensive data on the ownership of all U.S. hospitals that are enrolled in Medicare. This report provides an overview of the available data, a methodology for assigning hospitals to chains, and several preliminary analyses to showcase the data.

This Data Point examines new National Health Interview Survey (NHIS) data to assess recent changes in health coverage for the population. The most recent data finds that the national uninsured rate for all ages declined 1.9% from 2019 to 2022, with early 2023 data showing even greater decreases reaching an all-time low national uninsured rate of 7.7%.

Pathogens that have evolved to be resistant to the drugs currently used to treat infections are an ongoing threat to public health, animal health, food production, and national security. Globally, a recent analysis estimated that 1.2 million deaths were caused by antibiotic-resistant (AR) bacteria in 2019, making this threat a leading cause of death for people of all ages worldwide.

Expanding access to high-quality, affordable health care has been a priority of the Biden-Harris Administration.

This research report updates prior reports on Medicare FFS telehealth trends during the COVID-19 public health emergency with data through end of 2021, by beneficiary characteristics, visit specialty and geography including by state. Medicare telehealth flexibilities during the COVID-19 pandemic continued to encourage use of telehealth among Medicare beneficiaries in 2021.

ASPE contracted with RAND Health Care to catalogue and assess state changes to Medicaid telehealth policies during the COVID-19 PHE through May 2022 and identify the driving circumstances, motivations, and evidence supporting telehealth policy decisions during the COVID-19 Public Health Emergency (PHE).

This first report focuses largely on establishing a baseline and a framework for further evaluation.

The Inflation Reduction Act (IRA) will make key changes to improve drug affordability for people who have Medicare.

Researchers from ASPE, NORC, Washington University in St. Louis, Catholic Physicians’ Guild of San Antonio, and the U.S.

The U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Planning and Evaluation (ASPE) released new research on spending and utilization trends of Medicare Part B drugs, drugs administered in physicians' office or hospital outpatient departments rather than being purchased at the pharmacy counter or by mail order.

Below is a summary of the problems addressed, the solution, and the accomplishments and products. Problems Addressed: Researchers and public health officials frequently rely on the cause of death information made available from the coding and processing of death certificate data for critical programmatic, policy, and research needs.

This report summarizes the results of the evaluation conducted on different PPRL packages to identify the best fit for CODI. Included in the evaluation are the open source anonlink and the R PPRL package, as well as a commercial product called CURL (Colorado University Record Linkage), developed by the University of Colorado.

The product summaries include findings from three gaps analyses: CODI data needs, CODI query architecture, and differences between the VDW and CDM models. Recommendations are also provided on how to address the identified gaps.

This brief presents considerations for program administrators and other practitioners around increasing the use of primary prevention in human services systems to shift from responding to families after they are in crisis to preventing the crisis before it occurs.

This brief provides key considerations for policy designers and funding partners—such as federal staff, technical experts, and philanthropic partners—on incorporating primary prevention into human services delivery.

This brief highlights a new way of delivering primary prevention services that promotes equity by relying on the guidance and leadership of people with lived experience. The policy designers and service providers behind prevention services should have lived experience and/or co-create these services with people who do.

The goal of this project was to strengthen the coordinated registry network as a real-world data source for high quality, relevant, reliable, timely and actionable evidence to improve patient outcomes of medical devices, specifically for technologies affecting women’s health.

Enrollment in Medicare Advantage plans has increased rapidly in recent years. The share of eligible Medicare beneficiaries enrolled in MA rose from 25% in 2010 to 47% in 2021 (27.6 million enrollees). Payments to MA plans more than doubled between 2015 and 2021 (from $175 to $361 billion), taking the share of total Medicare Parts A & B spending on MA from 38% to 54%.

To fulfill HHS’s responsibility to understand and address social drivers of health and respond to President Biden’s Executive Order on Advancing Effective, Accountable Policing and Criminal Justice Practices to Enhance Public Trust and Public Safety, HHS conducted a review of the physical, mental, and public health impacts of law enforcement use of force and certain other police activities.

Prescription drug shortages are an ongoing concern in the United States (U.S.). While prior analyses explore the frequency of drug shortages in the U.S., little is known about the extent to which U.S. shortages impact consumer costs and healthcare systems. Drug shortages impact consumer costs in various ways.

The 2022 Office of the Secretary Patient-Centered Outcomes Research Trust Fund (OS PCORTF) Annual Report and infographic highlights the accomplishments of 32 multi-agency projects that supports the four goals of the new strategic plan: 

The purpose of this project was to develop and test a suite of electronic Care Plan (eCP) tools for adults with multiple chronic conditions (MCC), including an eCP implementation guide specifying data standards and value sets for key use case conditions and two open-source eCP apps (one for patients and one for clinicians).

Understanding Coverage Considerations for COVID-19 Vaccines and Treatments (Updated May 2023)

Executive summary This report describes the research plan and results of a PCOR project that followed a statement of work defined in an intra-agency agreement (IAA) between the Office of the Assistant Secretary for Planning and Evaluation (ASPE) and the National Library of Medicine (NLM). ASPE coordinates efforts to build data capacity for patient-centered outcomes research (PCOR).

Executive Summary Introduction and Background The Training Data for Machine Learning to Enhance PCOR Data Infrastructure project (hereafter termed the Project) led by the Office of the National Coordinator for Health Information Technology (ONC) conducted foundational work to support future applications of artificial intelligence (AI), specifically focused on machine learnin

Using a national Medicaid claims database, this brief estimates the number of pregnant beneficiaries with substance use disorder who lost Medicaid coverage 60 days postpartum at the national and state-level.

This report provides welfare dependence indicators through 2019 for most indicators and through 2020 for other indicators, reflecting changes that have taken place since enactment of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) in 1996.

This analysis identifies labor force trends of recently-arrived refugees, focused on the period after the start of the COVID-19 pandemic.

Telehealth utilization has changed over time since the steep increase from the early stages of the COVID-19 pandemic. This report updates prior findings on national trends of telehealth use through an analysis using the Census Bureau’s Household Pulse Survey data from April 2021 through August 2022.

Objectives: Clinical guidelines or guidance is an important tool for preventing and treating antimicrobial-resistant (AMR) infections. We sought to understand and support the effective use of guidelines and guidance for AMR infections.

Many Medicaid enrollees are employed, and in 2021, 15 percent of working enrollees reported having both Medicaid and employer sponsored health coverage. The intersection between Medicaid and employment has implications for employers and others as the pandemic-related Medicaid continuous enrollment ends.

ASPE has developed national and state estimates of the number of U.S. residents enrolled in Medicaid, along with data on employment, income, and demographic characteristics of those who are currently working, using the most recent Census data available from the 2021 American Community Survey (ACS).

This brief provides an overview of the important role Medicaid plays in postpartum maternal health, reviews states’ existing pregnancy-related Medicaid eligibility limits, and assesses the projected eligibility impact if all states were to provide 12 months of postpartum Medicaid eligibility. This Issue Brief updates a previous report that was originally published in December 2021.

Safety net programs provide critical support to people during times of economic hardship. Yet the reach and coverage of the safety net, particularly in times of increased need and among economically disadvantaged groups, is not well understood. The U.S.

This is the final report of an AHRQ study to address the operational gap between CFIs and EFIs. This project focused on validating an established CFI using linked claims-EHR databases of multiple large health systems. The project provides a systematic approach that health systems can use to examine the quality of the EHR data and prepare it for the application of EFI measures.

The Synthetic Health Data Generation to Accelerate PCOR project was launched in 2019 by the Office of the National Coordinator for Health Information Technology (ONC).

This issue brief provides a primer on FDA user fees, presents findings of how user fees affect the cost of medical product development, and summarizes the research literature on user fees, most notably in expediting medical product development and approval.

Using 2021-2022 survey data from the U.S. Census Bureau’s Household Pulse Survey, this ASPE Research Report examined sociodemographic factors and trends in vaccine hesitancy among workers based on the likelihood of exposure risk to SARS-CoV-2. We classified work setting into three categories: essential healthcare, essential non-healthcare, and non-essential.

This Issue Brief presents current estimates of enrollment in health insurance coverage obtained through the Affordable Care Act (ACA) Marketplaces, Medicaid expansion, Children's Health Insurance Program, Basic Health Program and the subsequent reductions in state-level uninsured rates since the ACA was implemented in 2014.

Effective January 1, 2023, the Inflation Reduction Act (IRA) eliminated enrollee cost-sharing for recommended vaccines covered under Medicare Part D. In 2021, 3.4 million people received vaccines under Part D, and annual out-of-pocket costs were $234 million.

The Fiscal Year (FY) HHS 2024 Evaluation plan lists a total of thirty-two (32) evaluations from ten (10) Operating and Staff Divisions across the U.S. Department of Health and Human Services (HHS).

This brief highlights key themes and ideas from a Health and Human Services (HHS) Convening on Advancing Primary Prevention in Human Services in August 2022. With a particular focus on prevention of youth and family homelessness, the convening featured the perspectives of academic experts, program administrators, federal colleagues, and people with lived expertise.

This Issue Brief examines children’s health coverage trends using the National Health Interview Survey from 2010 through the third quarter of 2022 and reviews recent research findings from the National Survey of Children's Health on children’s access to and utilization of health care services during this period, including the COVID-19 pandemic.

This ASPE Research Report summarizes findings about factors affecting Emergency Department wait times and Primary Care appointment scheduling intervals, and it describes strategies Indian Health Service (IHS) federal facilities have implemented associated with decreased wait times in Emergency Departments.Available Reports:

Zero Suicide is a system-wide approach for health systems to improve the quality and safety of care for those at risk of suicide, with the underlying goal of preventing all suicide deaths among patients. Although evidence has indicated that Zero Suicide is effective in reducing suicide-related outcomes, little is known about how organizations fund and sustain the Zero Suicide initiative.