ASPE Reports
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Report to Congress
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. On behalf of HHS, ASPE's Office of Human Services Policy has led the effort to stand up and…
Research Brief
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. Custody relinquishment could also occur to receive services not…
Report
Combating Antimicrobial Resistance During the COVID-19 Pandemic: Perceived Risks and Protective Practices
KEY POINTS
Report
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. The report also highlights the portfolio’s work on enhancing data standards,…
Report
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. Through an environmental scan and key informant interviews with clinical experts and people with lived experience of being diagnosed with…
ASPE Data Point
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. Yet little is known about what sets the people…
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. Each state adopts its own unique strategies…
Report
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.
ASPE Issue Brief
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. Contract nursing staff have become an important but costly…
ASPE Issue BriefReport
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. Technological innovation, large public investments, increased review resources, and greater…
ASPE Issue Brief
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. Gains in coverage are improving access and affordability of…
ASPE Issue Brief
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.
Report
Assessing the Feasibility of Creating a National Behavioral Health Workforce Database
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.
ASPE Issue Brief
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. ASPE commissioned RTI International to conduct an environmental scan and comparative analysis across peer-reviewed literature…
Report
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.
ASPE Issue Brief
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. Specifically, this study examines mental health and substance use disorder service use during the pandemic among Medicaid-covered children compared with use before the pandemic by service type, diagnosis, and use…
ASPE Issue Brief
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. During the COVID-19 pandemic, providers who delivered mental health or substance use disorder services (hereafter referred to as behavioral health services) rapidly transitioned their in-…
ASPE Issue BriefReport
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. We present a high-level approach for how to evaluate each IRA Medicare drug-related provision, including identification of key research questions and outcomes; the potential methods that can…
ASPE Issue Brief
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. In aggregate, the market achieves between zero and 42 percent return on investment (ROI) by the third year…