ASPE Reports
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ASPE Issue Brief
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. Among beneficiaries with Medicaid-paid births, postpartum health care use covered by Medicaid was higher during the COVID-19 public health emergency when extended Medicaid coverage was in place, with the…
ASPE Issue BriefReport
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. For older persons with few resources, Medicaid will pay for most of the costs, while those with more…
Report
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. This Draft Action Plan lays out four goals…
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.
ASPE Issue Brief
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. Policies that support…
Research Brief
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. This study is…
ASPE Issue Brief
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. This issue brief describes the reported impact of clinical trial participation on their financial well-being, explore the reported…
ASPE Issue Brief
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.
ASPE Issue Brief
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.
Report
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. This study uses multiple data sources to estimate the share of payer and…
ASPE Issue BriefReport
Behavioral Health Crisis Services: Insurance Reimbursement
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. States and communities use a variety of funding sources to support crisis services, such as public and…
Report
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.The report provides additional information on the data, methodology and results. Key findings are…
ASPE Issue Brief
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. Many barriers to care…
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.Key child…
Report
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.
ASPE Issue Brief
Hospice Agency Changes of Ownership: An Analysis of Publicly Available Ownership Issue Brief
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. We found a small…
Fact SheetReport
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. Although previous studies have captured some point-in-time estimates of participation in MSPs, few studies examine how participation trends in these…
Report
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
Report
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. Then, it examines the gross margins (hereinafter referred to as “margins”) of three primary intermediaries in the U…
ASPE Issue Brief
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. Beginning in 2025, the out-of-pocket catastrophic threshold, which determines entry into the catastrophic coverage phase, will be capped…