ASPE Reports
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Research Brief
States Increasingly Promote Kinship Care, though Significant Opportunity Remains for Improving Licensing, Definitions, and Reach: Nearly Two-Thirds of Jurisdictions Have Not Yet Amended Title IV-E Plans to Adopt Separate Licensing Standards
This brief explores how states are approaching kinship care by examining states’ definitions of kinship caregivers, the prevalence of children in foster care living with relatives or kin, states’ adoption of separate licensing standards for kinship homes, and states’ participation in kinship navigator programs through the Title IV-E Prevention Services Clearinghouse. Key findings include:
ASPE Data Point
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. Office of Management and Budget (OMB) covering all federal agencies and HHS Guidelines…
Report to Congress
Evaluation of the Impact of the No Surprises Act on Health Care Market Outcomes: Initial Post-Implementation Trends - Report Three
This third report extends trends in claims data in this series into 2022, the first year post-NSA implementation. In 2022, the prevalence of out-of-network bills declined 15 percent for emergency services and 11 percent for non-emergency services furnished at in-network facilities relative to 2021.
Research Brief
Administrative Costs Drive Foster Care Claims and Are Increasing Per Child as Caseloads Decline: Trends in Title IV-E Foster Care Expenditures FY2019-FY2023
This brief analyzes Title IV-E foster care program reported expenditures and reimbursements using the most recent years of publicly available claims data (from fiscal years 2019 to 2023). The content explores administrative costs, identifies how average monthly costs per child have changed over time, and provides a snapshot of the variation seen across states in FY2023. Key findings include:
Report
Behavioral Health Navigation Services Offered by Health Insurers: Models, Characteristics, and Perceived Impact
In the United States, accessing behavioral health care is a persistent and complex challenge, even among those with insurance coverage. Behavioral health care access challenges stem from a combination of provider shortages, systemic barriers, and logistical hurdles. People frequently encounter difficulties determining the type of provider or level of care that best suits their needs. Many are…
Research Brief
Head Start Spending Per Slot Varies Widely Across Grants, Driven in Part by Cost of Living and Local Program Design Factors
This brief presents information on Head Start spending per slot across the country. Key findings include:
Report
Medicare Advantage Plans & Evidence-Based Prevention Program Uptake
This report explores how Medicare Advantage (MA) plans deliver evidence-based prevention programs (EBPs) to support health promotion among older adults. Using an environmental scan and interviews with MA plan leaders, aging network stakeholders, and federal MA plan and EBP experts, the study examines how MA plans select, implement, and partner with community-based organizations to provide EBPs.…
ASPE Issue Brief
Approaches to Dementia Care in Special Needs Plans
This issue brief examines how Medicare Advantage Special Needs Plans (SNPs) address the care needs of people living with dementia (PLWD) and their caregivers. Drawing on an environmental scan and key informant interviews, the brief describes approaches to care coordination, dementia-specific training, and supplemental benefits offered through SNPs, including supports for non-medical needs and…
Report
Building the Data Capacity for Patient-Centered Outcomes Research: The 2025 Annual Report and Infographic
In Fiscal Year 2025, OS-PCORTF projects and other OS-PCORTF initiatives collectively enhanced the data infrastructure available for patient-centered and comparative clinical effectiveness research (CER) across national and HHS health objectives. OS-PCORTF projects are tackling critical health challenges that affect the wellbeing of all Americans, including chronic disease prevention and…
ASPE Issue Brief
Review of Federal and State Caregiver Tax Credit Laws and Bills
Unpaid caregivers play a vital role in supporting older adults and people with disabilities to remain in their homes and communities. They often face substantial financial and emotional strain from the burden of caregiving. In response, federal and state policymakers have advanced proposals to offer targeted tax relief to caregivers. The House and Senate introduced the Credit for Caring Act of…
Report
Identifying Disability with Medicaid Claims Data
Medicaid provides health insurance coverage and services and supports for people with disabilities, as well as groups of children and adults based on financial eligibility. While researchers have an understanding about some of the people with disabilities enrolled in Medicaid, such as those who qualify for Medicaid on the basis of a disability, less is known about those persons who might be…
Research Brief
Medicare Hospice Use Patterns Among Patients With Alzheimer’s Disease or Related Dementias Compared to Those With Other Terminal Diagnoses
This study examined how people with Alzheimer’s disease and related dementias (ADRD) use hospice compared with patients who have other terminal diagnoses, as well as how hospice characteristics shape those care patterns. The study found that ADRD was the third most common primary hospice diagnosis and frequently appeared as a secondary diagnosis, and in both cases was associated with longer…
Research Brief
Title IV-E Prevention Services Make Up Less Than Two Percent of Overall Program Expenditure Reimbursement Claims: Many States Do Not Claim Expenses at All
This brief, focused on the Title IV-E Prevention Program, explores how states, territories, and Tribes have been engaging in the program since it began. The content highlights the Title IV-E Prevention Services Clearinghouse process, as well as information from jurisdictions’ prevention plans and claimed expenditures. Key findings include:
Report
Better Data for Maternal Health Research HHS Efforts to Strengthen Data Infrastructure for a Healthy America
This 2024 vignette provides examples of how a range of OS-PCORTF cross-agency projects are working to improve maternal health by 1)Reducing Preventable Pregnancy-Related Deaths and Improving Maternity Care 2) Studying Substance Use Treatment Outcomes for Pregnant Women 3) Representing all American Mothers and Children in Research Data
Report
Exploring Data Infrastructure Availability and Expansion Opportunities for Health Outcomes Research on Sickle Cell Disease
This report is to serve as a data source guide that helps policymakers and researchers understand the current data infrastructure landscape for SCD-focused health outcomes research. Specifically, the goals are to identify existing SCD data sources and data dashboards as well as key considerations to enhance data collection and use. This report is intended to inform federal, academic, and…
ASPE Issue Brief
Opportunities for Technology-Enabled Care: Economic and Payment Issues
This Issue Brief explores opportunities that technology-enabled care (TEC) offers to help meet patient and provider needs for high-valued coordinated care to improve health outcomes. It explores literature surrounding existing available TEC options, as well as economic and payment issues that influence whether this is taken up.
Report to CongressVisualization
Welfare Indicators and Risk Factors, Twenty-Fourth Report to Congress
The Welfare Indicators Act of 1994 (Public Law 103-432) requires the Secretary of the Department of Health and Human Services to prepare an annual report to Congress on indicators and predictors of “welfare dependence.” That Act requires the report to include three programs: Temporary Assistance for Needy Families (TANF) program (which replaced the Aid to Families with Dependent Children (AFDC)…
Report
Multistate EMS and Medicaid Dataset (MEMD): A Linked Dataset for Patient-Centered Outcomes Research: Final Report
The U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) led the Multistate EMS and Medicaid Dataset (MEMD): A Linked Dataset for Patient-Centered Outcomes Research project which received funding in 2021 by the Office of the Secretary of HHS’s Patient-Centered Outcomes Research Trust Fund. This final report includes background…
Research Brief
No State Has Ever Passed the Child and Family Services Reviews: Findings from an Analysis Over the Last 25 Years
This brief synthesizes experiences over the past 25 years of the Child and Family Services Review (CFSR), providing an overview of the process, analyzing collective state performance across rounds, and highlighting costs and challenges. During that time, zero states have passed the CFSR process. Although the process does not seem to be driving program improvement, it is costly and burdensome.
Report
Data Sources for Conducting Research on Doula Services and Related Outcomes
Improving maternal health in the U.S. requires strengthening care and support during pregnancy, childbirth, and the postpartum period. Doula services have shown promise in improving maternal and infant outcomes, yet more research is needed to understand these impacts. This report aims to identify data sources for studying doula services, highlight gaps in current data infrastructure, and outline…