HP provides a cross-cutting policy perspective that bridges Departmental programs, public and private sector activities, and the research community, in order to develop, analyze, coordinate and provide leadership on health policy issues for the Secretary. HP carries out this mission by conducting policy, economic and budget analyses, assisting in the development and review of regulations, assisting in the development and formulation of budgets and legislation, assisting in survey design efforts, as well as conducting and coordinating research, evaluation, and information dissemination on issues relating to health policy.
The Office of Health Policy is organized in four divisions that align with major Department programs :Division of Health Care Financing Policy (HFP)
Division of Public Health Services (PHS)
Division of Health Care Access and Coverage (HAC)
Division of Health Care Quality and Outcomes (HQO)
HEALTH POLICY RESEARCH:
- Reports to Congress
- Affordable Care Act Research & Issue Briefs
- HP Authored or Sponsored Work Published in Journals
OTHER HELPFUL INFORMATION:
- Children's Health Insurance and CHIP
- Consumer Protection and Patient Safety
- Health Information and Statistics
- Health Policy
- Health Promotion and Disease Prevention
- Health Insurance Marketplace
- Healthcare Reform
- Other Research
- Patient-Centered Outcomes Research Trust Fund (PCORTF)
- Public Health
- Healthcare Safety Net
- Substance Abuse and Mental Health
This issue brief presents analysis of Qualified Health Plan (QHP) data in the individual market Marketplace for states that use the HealthCare.gov Marketplace platform and State-Based Marketplaces where data is available. It examines plan affordability in 2017 after taking into account premium tax credits and also examines the plan choices that new and returning consumers will have for 2017. This brief shows that the Affordable Care Act is continuing to promote affordability and choice in the Marketplace for plan year 2017.
This brief looks ahead to estimate how many individuals nationwide might select a Marketplace plan during the upcoming Open Enrollment period and how many – on average throughout 2017 – might have Marketplace coverage. By the end of open enrollment for 2017, we expect 13.8 million people to have selected a plan and we estimate that 11.4 million individuals will effectuate their enrollment on an average monthly basis over the course of 2017.
Rural Hospital Participation and Performance in Value-Based Purchasing and Other Delivery System Reform Initiatives
There are distinct challenges and opportunities for delivery system reform initiatives in rural hospitals. This report examines what is currently known about rural health and health care, in particular the hospital sector; examines the participation and performance of rural hospitals in delivery system reform efforts; and provides a discussion of potential enabling factors for and barriers to rural hospitals’ successful participation and performance in delivery system reform.
This issue brief provides a literature review of the effects of Medicaid expansion, with a focus on the impacts of the ACA’s Medicaid expansion in 2014 and 2015. Specifically, the brief focuses on the effects of expansion on health coverage and access, affordability and quality of care.
Health insurance rate information becomes available each spring as issuers file proposed rates with federal and state regulators. Rates then undergo review before being finalized in the fall, prior to the annual Health Insurance Marketplace Open Enrollment Period. Neither the proposed nor final rates offered by any individual issuer provide a reliable basis for predicting what typical Marketplace consumers will pay in the following year.
In this Issue Brief, we examine spending growth through 2014, the first year the Affordable Care Act’s coverage provisions were in effect, and 2015, where possible. We provide detailed cost growth trends for Medicare and the private insurance market. We also estimate the effect of recently introduced specialty drugs on current and future spending growth.
During the third open enrollment period, the Health Insurance Marketplaces (“the Marketplaces”) continue to play an important role in fulfilling one of the Affordable Care Act’s central goals: reducing the number of uninsured Americans by providing affordable, high-quality health insurance.
The dataset provides the total number of Qualified Health Plan selections by ZIP Code and county for the 38 states that use the HealthCare.gov platform, including the Federally-facilitated Marketplaces, State Partnership Marketplaces, and supported State-based Marketplaces, during the Marketplace’s third Open Enrollment Period (based on data for the period November 1, 2015 – February 1, 2016).
Medicare Part B covers infusible and injectable drugs and biologics administered in physician offices and hospital outpatient departments; as well as certain other drugs required by law provided by suppliers such as pharmacies The Part B payment method provides weak incentives for physicians to consider value – that is choose the lowest cost therapy to effectively treat a patient. Moreover, the Medicare program has not implemented various value based practices typically used by commercial insurers and Part D sponsors for self-administered drugs.
This issue brief reviews the most recent survey and administrative information available about gains in health insurance coverage since the enactment of the Affordable Care Act (ACA) in 2010. We estimate that the provisions of the ACA have resulted in gains in health insurance coverage for 20.0 million adults through early 2016 (through February 22, 2016), a 2.4 million increase since our previous estimate in September 2015. These estimated health insurance coverage gains are shared broadly across population groups.
Community Health Workers (CHWs) are an emerging group of health professionals that have recently drawn increased national attention because of their potential to deliver cost-effective, high quality, and culturally competent health services within team-based care models. The apparent benefits of integrating CHWs into health care teams seem to depend on context.
Addendum to the Health Insurance Marketplaces 2016 Open Enrollment Period: January Enrollment Report
This Addendum contains detailed State-level tables highlighting cumulative enrollment-related information for the Health Insurance Marketplaces (Marketplaces) during the the first part of the 2016 Open Enrollment period for all 50 states and the District of Columbia (11-1-15 to 12-26-15). These tables include data for These data are available for the 38 states that are using the HealthCare.gov platform for the 2016 coverage year (HealthCare.gov states), as well as for the 13 State-Based Marketplaces (SBMs) that are using their own Marketplace platforms for the 2016 coverage year.
Environmental Scan of Programs and Policies Addressing Health Disparities Among Rural Children in Poverty
About 12.9 million children live in rural communities, where they are more likely than their nonrural peers to experience health problems associated with their environment, their socioeconomic status, their own and their families’ health behaviors, and their access to quality clinical care. Despite the wealth of research regarding health disparities by income and race, there is limited information about policies and programs to address disparities among rural children. This environmental scan seeks to help fill this information gap.
By: Kenneth Finegold, Kelsey Avery, Bula Ghose, and Caryn Marks
The Affordable Care Act (ACA) provides two main avenues for expanding health coverage: the Health Insurance Marketplaces (“Marketplaces”) and the law’s federal support for states that wish to expand their Medicaid programs. This brief estimates how many individuals nationwide might have Marketplace coverage after the upcoming Open Enrollment period (November 1, 2015–January 31, 2016) through the end of 2016.
ASPE ISSUE BRIEF Steven Sheingold, Nguyen Nguyen, and Andre Chappel Disclaimer Persons with disabilities having problems accessing this document may call (202) 690-6870 for assistance.
July 2015 (Updated) The dataset provides the total number of Qualified Health Plan selections by county for the 37 states that use the HealthCare.gov platform, including the Federally-facilitated Marketplace, State Partnership Marketplaces and supported State-based Marketplaces for the Marketplace open enrollment period from November 15, 2014 through February 15, 2015, including additional special enrollment period (SEP) activity reported through February 22, 2015.
June 19, 2015 Tia Zeno, Katherine Warren, John Snyder
Medicare’s Hospice Benefit:Revising the Payment System to Better Reflect Visit Intensity May 28, 2015 Steve Sheingold, Susan Bogasky, and Sally Stearns I. Introduction