This brief describes how enhancing linked data infrastructure across health and human services programs can improve efficiency, increase transparency through strengthening outcomes research, and empower patients and families to make more informed choices.
Reports
Displaying 1 - 50 of 4395
Health Care and Child Care Costs Contribute to the Unsustainable and Growing Cost of Raising a Family in America
The cost of raising a family in America is high and continues to rise, with inflation rising by 23 percent between 2020 and 2025. For working families, some of the largest nondiscretionary expenses continue to be health care and child care.
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.
Understanding the Impact and Costs Associated with Medical Device Shortages During the COVID-19 Pandemic on Providers, Health Systems, Patients, and Manufacturers
We conducted a landscape analysis to understand the characteristics, impacts, and costs associated with medical device shortages during the COVID-19 pandemic in the U.S. Among health systems, nursing homes and rural hospitals were the most impacted by medical device shortages due to high demand and supply transportation issues.
Rebalancing of Medicaid-Funded Long-Term Services and Supports, 2016-2019
Shifting spending and delivery of long-term services and supports (LTSS) from institutions to the home and community is often referred to as rebalancing. This report and brief describe variation in LTSS rebalancing between 2016 and 2019 by enrollee age, health condition, and demographic factors.
Long COVID among Essential Workers, Non-Essential Workers, and Not Working Persons in the United States, 2022-2023
Topics
COVID-19
The Office of the Assistant Secretary for Planning and Evaluation (ASPE) released a report examining trends in prevalence of Long COVID among different types of workers and among individuals who were not working. Workers in different occupations face different risks of COVID infection, and, potentially, Long COVID, depending on the nature of their work.
Behavioral Health Prevalence, Utilization, and Spending Among Older Adult Medicare Beneficiaries: A Chartbook
Older adults with behavioral health disorders often experience worse health and functional outcomes, have higher rates of emergency department visits, use more medications, and have higher health care costs than those without a behavioral health disorder. There is need for a greater understanding of the extent to which older adults experience behavioral health disorders.
Trends in Medicaid and CHIP Telehealth Part III: Telehealth Utilization Trends Among Child Enrollees, 2019-2021
Topics
Healthcare Coverage & Access
This report examines national trends in telehealth service delivery to enrollees ages 0-18 years from 2019 to 2021, by enrollee characteristics such as age group and race and ethnicity. Services delivered via telehealth to pediatric Medicaid and CHIP enrollees rapidly expanded with the onset of the COVID-19 Public Health Emergency (PHE) in 2020 and remained higher than pre-PHE levels in 2021.
Postpartum Health Care Use in Medicaid During the COVID-19 Public Health Emergency: Implications for Extending Postpartum Coverage
This Issue Brief provides a descriptive analysis of postpartum health care use among the Medicaid population before and during the PHE, when the continuous enrollment condition was in effect.
Long-Term Services and Supports Reform
While the likelihood of needing any long-term services and supports (LTSS) is roughly a coin flip, the cost if one needs assistance for a long period of time can be catastrophic. For example, about one-in-five Americans turning age 65 today will have long-term care costs exceeding $200,000.
2025-2028 Draft Action Plan for Addressing Shortages of Medical Products and Critical Foods and Strengthening the Resilience of Medical Product and Critical Food Supply Chains
The 2025-2028 Draft Action Plan for Addressing Shortages of Medical Products and Critical Foods and Strengthening the Resilience of Medical Product and Critical Food Supply Chains (“Draft Action Plan”) presents coordinated and strategic actions that the Department of Health and Human Services (“HHS,” or “Department”) plans to take from 2025 through 2028.
Impact of MIPPA on Mental Health Service Utilization and Spending among Older Adults
In 2008, Congress passed the Medicare Improvements for Patients and Providers Act (MIPPA), in part to help improve access to outpatient mental health services. The legislation reduced Part B co-insurance rates for outpatient mental health services to be the same as the coinsurance rates for physical health rates. MIPPA gradually reduced cost-sharing rates over a 5-year period.
Drug Competition Series: Analysis of New Generic Markets Effect of Market Entry on Generic Drug Prices: Medicare Data 2007-2022
The U.S. has a number of policies related to drug pricing, affordability, and availability. To encourage manufacturers to innovate with new therapies, patent policy rewards the creation of new branded medicines. As those patents come to an end, generic drug manufacturers may enter a market and seek to sell their products at lower prices than the competing brand drugs.
Lessons for Human Services: Perspectives of Program Participants on Extreme Weather and Environmental Hazards
This brief summarizes results of interviews and focus groups with participants in human services programs about how they view extreme weather and other environmental hazards and their effects on families and communities. Participants discussed acute hazards such as flooding, as well as more chronic problems such as widespread trash, heat, poor air and water quality, and lead.
Financial stress associated with oncology clinical trial participation
To understand the size and impact of costs to clinical trial participants, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) conducted an exploratory survey of 112 U.S. adults who participated in an oncology clinical trial between 2018-2024.
The Impact of Alternative Payment Models on Medicare Spending and Quality, 2012-2022
We evaluated both the Center for Medicare and Medicaid Services Innovation Center (CMS Innovation Center) models and the Medicare Shared Savings Program (MSSP) and found that they have generated gross savings for all beneficiaries in the Traditional Medicare program while demonstrating positive impacts on selected quality measures.
Medicare Part B Enrollee Use and Spending on Biosimilars, 2018-2023
Biosimilars provide competition for biologics, which account for a significant and growing portion of Medicare Part B drug spending. This report evaluates the current state of biosimilar competition in Medicare Part B and explores opportunities to achieve further savings.
Profit Margins of Pharmaceutical Supply Chain Entities on Provider-Administered Drugs in Outpatient and Physician Settings
The U.S. supply chain for provider-administered outpatient drugs involves several entities, including drug manufacturers, wholesalers, healthcare providers (e.g., outpatient facilities, hospital pharmacies, doctor’s offices, and standalone clinics), group purchasing organizations (GPOs), payers, and beneficiaries.
Behavioral Health Crisis Services: Insurance Reimbursement
Topics
Behavioral Health
| Evidence-Based Policies & Practices
| Mental Health
| Opioids, Opioid Use Disorder, & Overdose Prevention
| Prevention
| Serious Mental Illness (SMI)
| Service Delivery & Capacity Building
| Substance Use & Substance Use Disorders (SUD)
| Suicide & Suicide Prevention
| Administrative Data
| Evidence-Based Policymaking
| Emergency Departments
| Injury, Violence, & Safety
| Preventive Services
The National Guidelines for Behavioral Health Crisis Care from the Substance Abuse and Mental Health Services Administration (SAMHSA) call for a sustainable infrastructure to respond to behavioral health crises, through crisis services that are accessible to anyone, anywhere, at any time.
Mergers and Acquisitions in Pharmaceutical Markets
This study, commissioned by ASPE, uses multiple data sources to 1) assess trends in pharmaceutical mergers and acquisitions (M&As) over the 2010-2023 period; 2) evaluate characteristics of drugs involved in M&As, and 3) examine the effects of M&As on the pharmaceutical supply chain.
Xylazine Response among Harm Reduction Organizations
Interviews were held with key informants from harm reduction organizations or similar programs from across the United States, to better understand how they are responding to the presence of xylazine in their communities. All participants noted an increase in xylazine prevalence in their communities, ranging from a years-long problem to first being identified in early 2023.
Improving Economic Mobility through Child Support: Opportunities for Future Research
This two-pager presents knowledge gaps and research opportunities elevated during a national convening of child support and child poverty experts. The questions under each topic are opportunities where research can support child support program decision-making surrounding current issues elevated during the convening, though they do not cover the only important questions for study.
Definitions and Occupational Characteristics of Direct Support Professionals
This study explores duties and activities that distinguish the DSP occupation from other direct care workforce occupations to inform the consideration of a DSP SOC code and other workforce data collection efforts. This study also identifies information beyond what is needed to create a DSP SOC code that states need on the DSP workforce to address policy and workforce planning activities.
Hospice Agency Changes of Ownership: An Analysis of Publicly Available Ownership Issue Brief
Topics
Hospice, Palliative Care
To improve Medicare provider and supplier enrollment data transparency, in 2023, the Centers for Medicare & Medicaid Services publicly released detailed ownership data, including data on change of ownership transactions, for Medicare-enrolled hospices. This brief presents a descriptive analysis of hospice agency changes of ownership nationally between 2018 and 2022.
Medicare Savings Programs: Eligibility and Enrollment Trends
Between 1988 and 1998, Congress established the Medicare Savings Programs (MSPs). MSPs are Medicaid programs that subsidize the cost of Medicare premiums, deductibles, co-insurance, and other cost sharing for Medicare beneficiaries with low incomes.
Analysis of Drug Shortages, 2018-2023
The report, "Analysis of Drug Shortages, 2018-2023" provides additional information on the data, methods, and findings. Below are the key findings.KEY POINTS
Pharmaceutical Supply Chain Intermediary Margins in the Retail Channel
The U.S. supply chain for prescription drugs is highly complex, involving several intermediaries between drug manufacturers and patients. This analysis estimates the percentages of drug expenditures that are allocated to each stakeholder in the supply chain, including manufacturers.
Inflation Reduction Act Research Series: Projecting the Impact of the $2,000 Part D Out-Of-Pocket Cap for Medicare Part D Enrollees with High Prescription Drug Spending
The Inflation Reduction Act includes many provisions that aim to reduce out-of-pocket spending for prescription drugs covered under Medicare Part D. In 2024, cost-sharing in the final phase of the Part D benefit, the catastrophic coverage phase, was eliminated.
Children's Interagency Coordinating Council (CICC) FY 2024 Report to Congress
Congress has directed HHS to operate 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.
Prevalence and Characteristics of Children Entering Foster Care to Receive Behavioral Health or Disability Services
Custody relinquishment occurs when children enter foster care primarily to receive behavioral health or disability services, not because of maltreatment. Parents may relinquish custody for a variety of reasons. Entering foster care could provide children with access to services that are otherwise unavailable due to limited capacity.
Building the Data Capacity for Patient-Centered Outcomes Research: The 2024 Annual Report and Infographic
The 2024 Office of the Secretary Patient-Centered Outcomes Research Trust Fund (OS-PCORTF) Annual Report highlights the data infrastructure accomplishments of over 40 multi-agency projects on topics of national importance such as maternal health, substance use disorder and intellectual and developmental disabilities.
Barriers to Attention-Deficit/Hyperactivity Disorder Diagnosis in Adults
Attention-deficit/hyperactivity disorder (ADHD) diagnosis and treatment among adults in the United States have increased over the past few decades. However, there are sex, racial, and ethnic disparities in diagnosis and treatment, and underdiagnosis persists.
Beyond Market Concentration: Using Social Network Analysis to Explore Complex Ownership Structures of Nursing Homes Data Point
CMS has actively worked to enhance ownership transparency in the nursing home industry through a series of data releases. This brief utilizes data from these new CMS initiatives to explore ownership and market structures of nursing homes, providing insights into the complexity and dynamics of nursing home ownership.
Supporting Families and Caregivers of Adults with Behavioral Health Disorders Issue Brief
There is limited research on the population who provide care and support for adults with serious mental health conditions, substance use disorders, or co-occurring mental health and substance use disorders (behavioral health disorders). The research that exists has shown they face many challenges, resulting in high caregiver stress and strain.
How Health Information Exchanges Support Integration for Behavioral Health Settings
States Health Information Exchanges (HIEs) can play a vital role in integrating BH and physical care by facilitating the exchange of patient information across different healthcare settings. In collaboration with ASPE, RTI investigated six states that have implemented a range of initiatives to support the integration of BH data systems into state HIEs.
Implementation of Mobile Medication Units: Findings from a Qualitative Study
In light of the continuing opioid epidemic in the United States, DEA lifted a moratorium on approvals of new mobile medication units (MMUs) to increase access to OTPs. The new DEA guidance also authorized OTPs to add a “mobile component” to their existing registration, eliminating the separate registration requirement for MMUs.
Use of Contract Staff in Nursing Homes Remains High After the COVID-19 Pandemic
Over one million Americans rely on nursing homes for care, yet nursing homes face challenges in recruiting and retaining staff. Nursing homes rely on registered nurses (RNs), licensed practical nurses (LPNs), and nursing assistants (NAs) to provide care, but staff shortages that increased during the COVID-19 pandemic have persisted.
New Estimates of the Cost of Preventive Vaccine Development and Potential Implications from the COVID-19 Pandemic
The ASPE issue brief examines the research and development cost and duration associated with bringing novel vaccines to the U.S. market. The results indicate that bringing a novel vaccine to the U.S. market costs an estimated $886.8 million on average, and its development process lasts 10 years.
Health Insurance Coverage and Healthcare Access from 2021-2024
This Issue Brief investigates how health insurance coverage, as well as healthcare access and affordability, has changed in recent years, with an emphasis on policies implemented from 2021 to 2024. Over 300 million Americans now have health insurance coverage. The U.S. uninsured rate has fallen significantly over the past four years.
Behavioral Health Service Use Among Medicaid and CHIP Enrollees Before/During the COVID-19 Public Health Emergency
In 2020, 53 million adults in the United States had a mental health condition and 40 million people ages 12 and older had a substance use disorder (SUD). The COVID-19 public health emergency (PHE) exacerbated mental health conditions and SUDs at a time when access to in-person care was restricted due to safety concerns.
Assessing the Feasibility of Creating a National Behavioral Health Workforce Database
Topics
Access to Services & Benefits
| Behavioral Health
| Care & Service Delivery Settings
| Evidence-Based Policies & Practices
| Mental Health
| Opioids, Opioid Use Disorder, & Overdose Prevention
| Peer Supports
| Prevention
| Rural Providers
| Serious Mental Illness (SMI)
| Service Delivery & Capacity Building
| Substance Use & Substance Use Disorders (SUD)
| Suicide & Suicide Prevention
| Telehealth & Virtual Service Delivery
| Workforce
| Administrative Data
| Data & Information Infrastructure
| Data Sources & Measurement
| Data Standards & Standardization
| Development of Data, Surveys, & Indicators
| Healthcare Coverage & Access
| Healthcare Delivery
| Integrated Care
| Patient-Centered Outcomes Research
| Physician Services
| Preventive Services
| Primary Care
The U.S. behavioral health (BH) workforce faces significant shortages and distribution disparities, hindering access to quality care and worsening health outcomes. A comprehensive, centralized database of BH providers is vital for advancing patient-centered outcomes research (PCOR), comparative effectiveness research (CER), and evidence-based policymaking.
Operationalizing the Definition of Intellectual and Developmental Disabilities in Administrative Claims Data for Research
The existence of multiple operational definitions for intellectual and developmental disabilities (ID/DD) in analyzing administrative claims data for health services and public health research limits translation of study findings to inform policies, programs, and practice.
The Implications of the No Surprises Act on Contract Dynamics, Negotiations, and Finances
To explore whether and how the NSA has affected insurer-provider dynamics, contract negotiations, and payment rates, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) asked RAND to conduct discussions with stakeholders. In this report, RAND summarizes the approach exploring these topics, the themes that emerged from our discussions, and areas for additional inquiry.
Treatment for Children and Adolescents Enrolled in Medicaid and CHIP During COVID-19
The first brief below provides insight into children’s and adolescents’ mental health service use in Medicaid and CHIP during the pandemic, by using a national Medicaid claims database.
Medicaid Behavioral Health Providers Delivering Most Behavioral Health Services via Telehealth Before and During the COVID-19 Pandemic Issue Brief
The goal of this study was to examine the extent to which Medicaid providers who deliver behavioral health services shifted their practices to mostly tele-behavioral health services during the COVID-19 pandemic.
An Evaluation Framework for the Inflation Reduction Act’s Medicare Prescription Drug Related Provisions
The Inflation Reduction Act (IRA) changes the way Medicare pays for prescription drugs. These changes will impact various stakeholders, including Medicare, Medicare enrollees, drug manufacturers, and others.
An Examination of the Return on Investment of Generic Injectable Prescription Drugs
The generic injectable drug market has recently experienced numerous shortages, which impose substantial public health costs. One potential cause of these shortages is low profitability of generic injectables. This brief examines the profitability of recently launched generic injectables.
New Jersey Home Care Workforce Case Study: Final Report
This New Jersey case study provides insights into the daunting challenges states face in seeking to address the home care worker shortage, which has become more acute as New Jersey and other states have striven to “re-balance” Medicaid long-term services and supports use and spending away from institutional care toward home and community-based services.