The Centers for Medicare and Medicaid Services (CMS) uses the Star Rating program to measure the quality of Medicare Advantage (MA) plans, publicly report plan performance, and determine quality bonus payments and rebates for MA plans.
Health & Health Care
ASPE produces health policy research with a focus on equity, coverage, and access. Find resources related to a broad range of topics, including the uninsured population, vaccine hesitancy, Medicaid/CHIP, Medicare, the federal marketplace (HealthCare.gov), telehealth, health care delivery, underserved areas, delivery system transformation, health outcomes, and social determinants of health.
Noteworthy Resources and Reports
Vaccine Hesitancy for COVID-19: State, County, and Local Estimates
To support state and local communication and outreach efforts, ASPE developed state, county, and sub-state level predictions of hesitancy rates using the most recently available federal survey data. Explore the interactive map and other resources.
Topic Areas
Reports
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Advanced SearchEnvironmental Scan
Types and Costs of Services for Dual Beneficiaries by Medicare Advantage Health Plans: An Environmental Scan
Addressing Social Determinants of Health Needs of Dually Enrolled Beneficiaries in Medicare Advantage Plans: Findings from Interviews and Case Studies
Medicare Advantage (MA) plans that serve relatively higher proportions of dually enrolled beneficiaries have lower ratings in the MA Star Rating program than plans that serve fewer dually enrolled beneficiaries. However, some MA plans that serve a high proportion of dually enrolled beneficiaries are high performers.
ASPE Data Point
Data point: Prescription Pharmaceutical Price Changes since the Release of the President’s Drug Pricing Blueprint
Using manufacturer-reported prescription pharmaceutical prices, we observe that the number of price increases has been reduced considerably since the release of the President’s Drug Pricing Blueprint, compared to the same time period in the year prior.
An Overview of Long-Term Services and Supports and Medicaid: Final Report
Nga T. Thach, BS, and Joshua M. Wiener, PhD RTI International May 2018 Printer Friendly Version in PDF Format (34 PDF pages)
State and Local Policy Levers for Increasing Treatment and Recovery Capacity to Address the Opioid Epidemic: Final Report
This report summarizes financing and workforce policies that can be used by states to expand treatment access and capacity for opioid use disorder (OUD), focusing especially on medication-assisted treatment (MAT).
Examining Substance Use Disorder Treatment Demand and Provider Capacity in a Changing Health Care System: Final Report
Federal policies implemented in the last decade, including the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act, have promoted insurance coverage for substance use disorders (SUDs). By providing funding for treatment services, these federal policies were intended to increase the proportion of individuals with SUDs who seek and receive evidence-based treatments.
2017 Annual Report of HHS Projects to Build Data Capacity for Patient-Centered Outcomes Research
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.
ASPE Data Point
Data Point: Savings Available Under Full Generic Substitution of Multiple Source Brand Drugs in Medicare Part D
ASPE analyzed Part D prescription drug event data from 2016 to estimate spending on brand drugs with generic therapeutic equivalents.
ASPE Issue Brief
Substance Use Disorder Workforce Issue Brief
Many barriers to accessing evidence-based treatment for substance use disorder (SUD), particularly medication assisted treatment, are related to the workforce. Barriers include workforce shortages for certain providers, insufficient training, education and experience, lack of institutional and clinician peer support, provider stigma and inadequate or burdensome reimbursement.
Patient-Centered Medical Home Implementation in Indian Health Service Direct Service Facilities
This report summarizes strategies Indian Health Service (IHS) clinics have used to implement the Patient-Centered Medical Home (PCMH) model of care, challenges they faced during implementation, and lessons learned that might benefit IHS clinics that have not yet received PCMH recognition. Common strategies to address challenges include use of telemedicine and partnerships with academic me