Reports

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%.

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.Related Products:

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 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.

This report summarizes the identified practices of the Medicaid Reentry Stakeholder Group and, as required by Section 5032 of the SUPPORT Act, informs design of a demonstration opportunity “under Section 1115 of the Social Security Act (42 U.S.C.

This guide highlights questions for health and human services staff to consider and discuss as a team before recruiting individuals with lived experience, as well as key content to consider including in outreach materials.

This tool highlights concrete strategies that health and human services staff can use to help identify people with lived experience to engage.

This infographic describes key elements of lived experience in the context of health and human services work, and why engaging people with lived experience is essential to ensuring our services reach all people.Related Products:

Effective January 1, 2023, out-of-pocket costs for insulin are capped at $35 per monthly prescription among Medicare Part D enrollees under the Inflation Reduction Act (IRA). A similar cap takes effect in Medicare Part B on July 1, 2023.

Social safety net programs provide different types of support to people facing economic hardship. This data point presents estimates of overall participation in the social safety net in 2019, the latest year of available data and presents rates of participation in multiple programs.Key Points:

People facing economic instability often need more than one program or service. This pre-pandemic analysis looks at the reach of the social safety net, including the interaction of specific programs, to better understand program participation as the economy continues to recover.Key Points:

This brief explores important trends in the child care industry during the first two years of the COVID-19 pandemic and places those trends in a historical context. Specifically, we find:

This report provides information to state, tribal, and local child welfare and behavioral health agencies that are interested in linking their Medicaid and child welfare data.

This Issue Brief examines the composition of the population that is uninsured and highlights changes in uninsured rates by geography and demographic factors from 2019 to 2021, during a time of significant federal policy efforts to expand coverage.

ASPE recently published a narrative review in PLOS Digital Health exploring how synthetic data are being used. Researchers searched published literature and known, publicly available synthetic datasets.

This report examines the utilization of oral antiviral medications, Paxlovid and Lagevrio, for the treatment of COVID-19. The analyses include an examination of time trends of COVID-19 antiviral use as well as breakdowns by age cohorts and sex. The report finds that utilization in the U.S.

This Report to Congress examines the critical role that insulin plays in the treatment of diabetes, reviews evidence on how insulin affordability affects adherence to insulin treatment and affects downstream health consequences, and describes policy efforts to improve the affordability of insulin.

To enhance transparency in health care markets, in September 2022, the Centers for Medicare & Medicaid Services (CMS) publicly released comprehensive data on the ownership of all U.S. skilled nursing facilities (SNFs) that are enrolled in Medicare. This report provides an overview of the available data, a methodology for calculating the ownership shares by individuals vs.

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 early childhood and family well-being outcomes across federal programs that support expectant parents, children ages 0 to 8, and their families.

Doulas provide emotional, physical, and informational support before, during, and after labor and birth.

Shortages of critical medical devices during the COVID-19 pandemic exposed vulnerabilities in device markets. From 2010 to 2019 there were approximately five shortages annually, but that number increased fourfold in the first half of 2020.

In April 2021 the U.S. Department of Health and Human Services (HHS) issued revised Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder (Practice Guideline).

The authors conducted a landscape scan to identify environmental data suitable for health services research (HSR) and patient centered outcomes research (PCOR). Additional research was done to uncover examples of and opportunities for data linkage with other HHS data.

In this brief, we highlight experiences and practices from substance use treatment providers and their human services partners when serving people of color. We selected providers that focused on serving people of color, and this study was not intended to assess outcomes or effectiveness of any of the practices highlighted.

This updated 2022 vignette provides examples of how a range of Office of the Secretary Patient-Centered Outcomes Research Trust Fund (OS-PCORTF) cross-agency projects are working to address the opioid overdose crisis by 1) Improving Timeliness and Quality of Outcomes Data 2) Building Capacity for Collection of Patient-Reported Outcomes 3) Building Linkages to Address Co-Morbidities

This issue brief provides updates on state Medicaid policies regarding delivery of telehealth services by provider types and modalities, as of January 2022. The COVID-19 pandemic substantially accelerated interest in and utilization of telehealth across all payers including Medicaid.

Methodological Description

This updated 2022 vignette provides examples of how a range of the Office of the Secretary Patient-Centered Outcomes Research (OS-PCORTF) cross-agency projects are working to improve maternal health by 1) Enhancing Women’s Health Data for Research 2) Adding Electronic Health Records to the Suite of Maternal Health Data for Research 3) Linking Maternal Survey Data with Other Health Data.