Prescription drug price increases create affordability challenges for patients and for the government. This report tracks drug price changes from 2016-2022. There were 1,216 products whose price increases during the twelve-month period from July 2021 to July 2022 exceeded the inflation rate of 8.5 percent for that time period. The average price increase for these drugs was 31.6 percent.
Reports
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Resident and Facility Factors Associated with High Risk of Discharge from Nursing Facilities, 2012-2017: Issue Brief
This project tracked resident and facility factors associated with high risk of live discharges from nursing facilities.
Resident and Facility Factors Associated with High Risk of Discharge from Nursing Facilities, 2012-2017: Final Report
This project tracked resident and facility factors associated with high risk of live discharges from nursing facilities.
High Risk of Discharge from Nursing Facilities
People can be discharged from nursing homes for many reasons. Discharges may be a positive outcome and at an individual’s choice. In other cases, discharges may be at the direction of the facility and against the will of the resident. There are strict rules about when involuntary facility-initiated discharges (FIDs) are allowed.
Long-Term Services and Supports for Older Americans: Risks and Financing, 2022
This Brief presents information about the risk of needing care and associated costs to provide content for policymakers and others considering long-term care financing proposals. It revises a brief that was written in October 2020.
Many Children in HHS Safety Net Programs Are Eligible for Nutrition Assistance But Are Not Enrolled
Nutrition assistance programs have been shown to increase children’s health and well-being and decrease the risk of child maltreatment. At the same time, food insecurity rose in the early days of the COVID-19 pandemic.
Landscape of Area-Level Deprivation Measures and Other Approaches to Account for Social Risk and Social Determinants of Health in Health Care Payments
Improving health equity in the United States is a priority for the Biden-Harris Administration in order to address longstanding disparities in health outcomes. Health inequities can be conceptualized and measured as drivers of differences in health outcomes.
HHS Roadmap for Behavioral Health Integration
This brief introduces the HHS Roadmap for Behavioral Health Integration, which advances the President’s Strategy to Address our National Mental Health Crisis. It provides a general overview of the approach HHS is taking to drive toward integrated care within the three pillars of the President’s Strategy and highlights selected programs and policy actions that will get us there.
Factsheet: Estimates of Child Care Eligibility & Receipt for Fiscal Year 2019
This factsheet provides descriptive information on child care eligibility and receipt. Of the 12.5 million children potentially eligible for child care subsidies under federal rules, 16 percent received subsidies. Of the 8.7 million children eligible for child care subsidies under more restrictive state rules, 23 percent received subsidies.
Flexibilities in Controlled Substances Prescribing and Dispensing During the COVID-19 Pandemic
The COVID-19 pandemic had wide-ranging impacts on health care delivery, particularly services that require in-person interactions. For patients needing access to medications to treat pain or certain substance use disorders, the COVID-19 pandemic presented particular challenges for continuity of treatment.
State Use of Value-Based Payment in Nursing Facilities Issue Brief
Payers across the health care spectrum have begun transitioning from paying for quantity toward paying for quality. These value-based payment (VBP) programs vary in scope and focus, but generally share the goals of improving cost-savings and linking payments to value rather than volume.
Developing and Assessing the Validity of Claims-based Indicators of Frailty and Functional Disabilities in Electronic Health Records
This project focused on validating an established claims-based frailty indexes (CFI) using linked claims-EHR databases of multiple large health systems. Additionally, the project assessed and compared the EHR and claims data of these data sources to ensure sufficient data quality for frailty analysis.
Unwinding the Medicaid Continuous Enrollment Provision: Projected Enrollment Effects and Policy Approaches
This report provides current HHS projections of the number of individuals predicted to lose Medicaid coverage at the end of the COVID-19 public health emergency (PHE) due to a change in eligibility or due to administrative churning.
Environmental Scan on Consolidation Trends and Impacts in Health Care Markets
This contractor report describes the landscape of market consolidation across the U.S. health care system and analyzes the evidence on the price, cost, and quality effects of consolidation.
Opioid Use in Long-Term Care Settings: Final Report
Opioid use was very common among the long-term care (LTC) residents in our sample. Perhaps reflecting their post-acute rehabilitative needs, discharged residents were more likely to have opioid use prior to LTC admission and at the beginning of the LTC stay.
National Uninsured Rate Reaches All-Time Low in Early 2022
This Data Point examines new Health Interview Survey data to assess recent changes in coverage, finding that the uninsured rate declined throughout 2021 and early 2022 – reaching a historic low of 8.0% by the first quarter of 2022. This reflects 5.2 million people gaining coverage since 2020.
Opportunities to Improve Data Interoperability and Integration to Support Value-Based Care
In value-based models of health care delivery, providers are financially rewarded or penalized on the basis of the quality of care they provide to patients, typically measured by patient outcomes.
Improving Data Infrastructure for Patient-Centered Outcomes Research for People with Intellectual and Developmental Disabilities
This report describes insights gained from key informant interviews and an ASPE-hosted listening session on short-term opportunities for improving patient-centered outcomes research (PCOR) data infrastructure that addresses the needs of individuals with intellectual and developmental disabilities (ID/DD).
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How Increased Funding Can Advance the Mission of the Indian Health Service to Improve Health Outcomes for American Indians and Alaska Natives
This ASPE report discusses disparities in health and health care experienced by American Indian and Alaska Native (AI/AN) populations, the role of the federal government in financing and providing health care services to these populations, and how enhanced funding could help further the Indian Health Service’s mission in ensuring that tribal communities have access to high quality health care s
Report to Congress: Unified Payment for Medicare-Covered Post-Acute Care
Topics
Post-Acute Care & Services
The Improving Post-Acute Care Transformation (IMPACT) Act of 2014 requires a report to Congress on unified payment for Medicare post-acute care (PAC). Medicare PAC providers are skilled nursing facilities, inpatient rehabilitation facilities, long-term care hospitals, and home health agencies. Each PAC provider setting has a separate Medicare fee-for-service prospective payment system.
Marketplace Coverage and Economic Benefits: Key Issues and Evidence
This report highlights the impacts of the Affordable Care Act's Marketplace subsidies on coverage rates among self-employed adults and small business owners, based on tax data from the Department of Treasury and national survey data.
Advancing Equity for Fathers in Human Services Programs
Topics
Care & Service Delivery Settings
| Case Management
| Prevention
| Service Delivery & Capacity Building
| Adoption & Foster Care
| Child Care
| Child Maltreatment
| Child Support
| Child Welfare
| Early Care & Education
| Early Childhood Development
| Family Well-Being
| Fatherhood
| Human Trafficking
| Intimate Partner Violence (IPV)
| Marriage & Family Issues
| Maternal & Child Health
| Parenting
| Teen Pregnancy
| Transition to Adulthood
| Youth Development
| Access to Services and Benefits & Services Integration
| Equity
This practice guide is a resource for a broad range of human services programs aiming to be more inclusive of and responsive to fathers. Building on literature from the field and interviews with human services providers that engage fathers in services, this guide outlines strategies for advancing equity in human services programs:
Changes in Ownership of Skilled Nursing Facilities from 2016 to 2021: Variations by Geographic Location and Quality
Newly released CMS skilled nursing facilities (SNF) Change of Ownership data (CHOW) data allows for a better understanding of how the nursing home ownership financial structures are changing. A total of 3,258 SNFs have been sold since 2016. Roughly 3.5% of skilled nursing facilities are sold in the US each year since then.
International Prescription Drug Price Comparisons: Current Empirical Estimates and Comparisons with Previous Studies
Key FindingsPolicy discussion surrounding U.S. prescription drug prices focuses on whether prices in the United States are too high or appropriate relative to the benefits that they offer to patients.
Linking State Health Care Data to Inform Policymaking: Opportunities and Challenges
Topics
Care & Service Delivery Settings
| Evidence-Based Policies & Practices
| Prevention
| Privacy & Confidentiality
| Service Delivery & Capacity Building
| Administrative Data
| Data & Information Infrastructure
| Data Policy
| Data Quality
| Data Security
| Data Sharing & Interoperability
| Data Standards & Standardization
| Development of Data, Surveys, & Indicators
| Information Quality
| Economic Impact Analysis
| Evidence-Based Policymaking
| Cancer
| Chronic Conditions & Illnesses
| Health Equity
| Health Insurance
| Healthcare Delivery
| Prescription Drug Benefits
| Preventive Services
| Primary Care
| Data & Statistical Policy
| Health Policy
| Healthcare Financing & Expenditures
| Out-of-Pocket Costs
| Price Transparency
This posting includes a report prepared by the RAND Corporation, “State All Payer Claims Databases Understanding the Current Landscape and Challenges to Use,” which builds on a 2021 report “The History, Promise and Challenges of State All Payer Claims Databases.” The new report provides additional detail on the objectives of and use cases for APCDs, the current APCD landscape, and implementatio
Survey on Substance Use Disorder Patient Placement Criteria and Assessments
To identify and address gaps in substance use disorder (SUD) treatment capacity, state and federal policymakers need information on the need and demand for different SUD levels of care. To develop this information, this project fielded a survey of Single State Agencies for Substance Use Services and Medicaid agencies to every state and the District of Columbia.
Imputation of Race and Ethnicity in Health Insurance Marketplace Enrollment Data, 2015 – 2022 Open Enrollment Periods
The Assistant Secretary for Planning and Evaluation (ASPE) contracted with RAND Health Care to develop methods for imputing race and ethnicity among people who selected Marketplace plans on HealthCare.gov but did not report their race or ethnicity, and to apply these methods to data from the 2015 to 2022 Open Enrollment Periods.
Federal Efforts to Address Racial and Ethnic Disparities in Alzheimer’s Disease and Related Dementias
The National Alzheimer’s Project Act (NAPA) requires “the inclusion of ethnic and racial populations at higher risk for Alzheimer's or least likely to receive care, in clinical, research, and service efforts with the purpose of decreasing health disparities in Alzheimer's”.1 In order to meet this requirement, in 2020 the Advisory Council on Alzheimer’s Research, Care, and Services recommended t
Early Childhood Systems Collective Impact Project: Overview
The Early Childhood Systems Collective Impact Project (ECS Collective Impact Project) will help to re-envision a truly coordinated approach to program implementation designed to advance equitable early childhood and family well-being outcomes across federal programs that support expectant parents, children ages 0 to 8, and their families.
Building the Data Capacity for Patient-Centered Outcomes Research: The 2021 Annual Report Executive Summary and Full Report
The 2021 Office of the Secretary Patient-Centered Outcomes Research Trust Fund (OS PCORTF) Annual Report Executive Summary and Full Report highlights the accomplishments of 34 multi-agency projects to build data capacity and support the mission of HHS to advance science and improve knowledge about the comparative effectiveness of health care interventions.
Challenges to Identifying and Supporting Human Services Participants with Substance Use Disorder
This brief summarizes an environmental scan and series of key informant interviews describing the challenges that human services programs face in identifying participants with substance use disorders (SUD), and subsequently referring them to treatment. The review focused on child welfare services, domestic violence services, Head Start, and Temporary Assistance for Needy Families.
National Action Plan for Combating Antibiotic-Resistant Bacteria Progress Report: Year 5
The National Action Plan for Combating Antibiotic-Resistant Bacteria 2015 – 2020 (2015 Plan) has guided the U.S. Government’s response to combating antibiotic-resistant infections since its establishment in 2015. The U.S. Government’s Interagency Task Force for Combating Antibiotic-Resistant Bacteria (CARB) has produced four previous reports on progress toward the 2015 Plan.
Mitigating Direct Care Workforce Injuries in Homecare: A Summary of the Evidence
Due to the increasing demand for homecare workers and the high rate of occupational injuries among these workers, addressing homecare worker safety is critically important. High injury rates among homecare workers contribute to turnover and absenteeism, and lead to high costs of workers’ compensation insurance for employers.
Practice Guide: Strengthening Partnerships Between Fatherhood and Human Services Programs to Improve Father Engagement
This practice guide is a resource for a broad range of human services and fatherhood programs aiming to be more inclusive of and responsive to fathers. Building on literature from the field and interviews with human services providers that engage fathers in services, this guide outlines the benefits of developing community partnerships between father-focused and other human services programs.
Connecting Youth During the COVID-19 Pandemic
This infographic explores the impact the COVID-19 pandemic had on programs that support young people, ages 16-24, who experience disconnection from school and work, often referred to as "opportunity youth." It provides an overview of which education, job training, and supportive services, in addition to enrollment and implementation practices were added or ended during the first year (spring 20
Hospitalization Cost Savings Associated with COVID-19 Vaccinations Among Medicare Beneficiaries in Early 2021
Using Medicare FFS claims data and county-level vaccination rates, we estimate savings of about $2.6 billion from reduced Medicare hospitalizations associated with COVID-19 vaccinations in early 2021.
Impact of the COVID-19 Pandemic on the Hospital and Outpatient Clinician Workforce: Challenges and Policy Responses
The COVID-19 pandemic has put extreme stress on the health care workforce in the United States, leading to workforce shortages as well as increased health care worker burnout, exhaustion, and trauma.
Continuity of Care Services Following Coordinated Specialty Care: An Environmental Scan
Topics
Disability
| Home- & Community-Based Services (HCBS)
| Behavioral Health
| Care & Service Delivery Settings
| Case Management
| Evidence-Based Policies & Practices
| Mental Health
| Peer Supports
| Serious Mental Illness (SMI)
| Service Delivery & Capacity Building
| Social Determinants of Health
| Substance Use & Substance Use Disorders (SUD)
| Telehealth & Virtual Service Delivery
| Workforce
| Transition to Adulthood
| Youth Development
| Integrated Care
| Independent Living
This report provides an overview of transition services for clients graduating from Coordinated Specialty Care (CSC). CSC Programs have been successfully implemented across the US, including through support from the Community Mental Health Services Block Grant set aside funds for people with early psychosis.
Transition Options, Opportunities for Integration, and Funding Considerations Following Coordinated Specialty Care Issue Brief
Topics
Care Coordination
| Cognitive Impairment
| Home- & Community-Based Services (HCBS)
| Behavioral Health
| Care & Service Delivery Settings
| Case Management
| Evidence-Based Policies & Practices
| Mental Health
| Privacy & Confidentiality
| Serious Mental Illness (SMI)
| Service Delivery & Capacity Building
| Social Determinants of Health
| Substance Use & Substance Use Disorders (SUD)
| Telehealth & Virtual Service Delivery
| Workforce
| Youth Development
| Healthcare Delivery
| Integrated Care
| Access to Services and Benefits & Services Integration
| Independent Living
| Public Health Policy
This brief is the third publication from the Continuity of Care Services Following Coordinated Specialty Care study. It provides a short overview of the different approaches to continuity of care for young adults who have attended CSC programs and explores avenues for integration within programs and organizations as a way to support young adults following a completion of a CSC program.
The Coordinated Specialty Care Transition Study: Final Report
Topics
Aging & Disability
| Care Coordination
| Cognitive Impairment
| Home- & Community-Based Services (HCBS)
| Behavioral Health
| Behavioral Health
| Care & Service Delivery Settings
| Case Management
| Evidence-Based Policies & Practices
| Mental Health
| Privacy & Confidentiality
| Serious Mental Illness (SMI)
| Service Delivery & Capacity Building
| Social Determinants of Health
| Substance Use & Substance Use Disorders (SUD)
| Telehealth & Virtual Service Delivery
| Workforce
| Health & Health Care
| Healthcare Delivery
| Integrated Care
| Human Services
| Access to Services and Benefits & Services Integration
| Long-Term Services & Supports, Long-Term Care
| Independent Living
| Policy & Regulation
| Public Health Policy
| Public Health
The Coordinated Specialty Care Transition Study: Final Report provides an overview of transition services for clients graduating from Coordinated Specialty Care (CSC). This the second publication from the Continuity of Care Services Following Coordinated Specialty Care study.
Health Coverage Changes Under the Affordable Care Act: End of 2021 Update
This report examines recently-released 2021 National Health Interview Survey data to assess coverage changes during the pandemic, finding a decrease in the uninsured rate in 2021 for the population as a whole and by race, ethnicity, and income.
Welfare Indicators and Risk Factors, 21st Report to Congress
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.
Building the Data Capacity for Patient-Centered Outcomes Research: The 2016 Annual Report
The OS-PCORTF Annual Report provides project descriptions for each of the OS-PCORTF portfolio’s 18 projects that were active in calendar year 2016.
Building the Data Capacity for Patient-Centered Outcomes Research: The 2017 Annual Report
The OS-PCORTF Annual Report provides project descriptions for each of the OS-PCORTF portfolio’s 21 projects that were active in calendar year 2017.
Building the Data Capacity for Patient-Centered Outcomes Research: The 2018 Annual Report
The OS-PCORTF Annual Report provides project descriptions for each of the OS-PCORTF portfolio’s 25 projects that were active in calendar 2018.
Building the Data Capacity for Patient-Centered Outcomes Research: The 2019 Annual Report
The OS-PCORTF Annual Report provides project descriptions for each of the OS-PCORTF portfolio’s 27 projects that were active in calendar year 2019, as well as the major accomplishments.
Building the Data Capacity for Patient-Centered Outcomes Research: The 2020 Annual Report
The OS-PCORTF Annual Report provides project descriptions for each of the OS-PCORTF portfolio’s 34 projects that were active in calendar year 2020, as well as the major accomplishments.
Changes in Ownership of Hospital and Skilled Nursing Facilities: An Analysis of Newly-Released CMS Data
This report analyzes newly-released data from CMS that provides information on changes in ownership among hospitals and skilled nursing facilities (SNFs), based on information reported to CMS through the Provider Enrollment, Chain, and Ownership System (PECOS).
Quality of Federal COVID-19 Data
This analysis applies the Federal Committee on Statistical Methodology's Data Quality Framework to assess the data quality of federal data for understanding and responding to the COVID-19 pandemic, focusing on five COVID-19 indicators: testing, cases, hospitalizations, deaths, and vaccinations.
Antipsychotic Medication Prescribing in Long Term Care Facilities Increased in the Early Months of the COVID-19 Pandemic Issue Brief
Prescriptions dispensed for antipsychotics in nursing homes and assisted living facilities increased since the beginning of the pandemic, with 20.8 thousand dispensed in 2020 compared to 20.5 thousand in 2019. This represents a 1.5% increase in total prescriptions since the beginning of the pandemic despite lower resident census levels in long-term care facilities (LTCFs).