HP provides a cross-cutting policy perspective that bridges Departmental programs, public and private sector activities, and the research community, in order to develop, analyze, coordinate and provide leadership on health policy issues for the Secretary. HP carries out this mission by conducting policy, economic and budget analyses, assisting in the development and review of regulations, assisting in the development and formulation of budgets and legislation, assisting in survey design efforts, as well as conducting and coordinating research, evaluation, and information dissemination on issues relating to health policy.
The Office of Health Policy is organized in four divisions that align with major Department programs :
Division of Health Care Financing Policy (HFP)Division of Public Health Services (PHS)
Division of Health Care Access and Coverage (HAC)
Division of Health Care Quality and Outcomes (HQO)
HEALTH POLICY RESEARCH:
- Reports to Congress
- Affordable Care Act Research & Issue Briefs
- HP Authored or Sponsored Work Published in Journals
OTHER HELPFUL INFORMATION:
TOPIC AREAS:
- Children's Health Insurance and CHIP
- Consumer Protection and Patient Safety
- Health Information and Statistics
- Health Policy
- Health Promotion and Disease Prevention
- Health Insurance Marketplace
- Healthcare Reform
- HIV/AIDS
- Medicaid
- Medicare
- Other Research
- Patient-Centered Outcomes Research Trust Fund (PCORTF)
- Public Health
- Healthcare Safety Net
- Substance Abuse and Mental Health
- Uninsured
NEW REPORTS:
Medicaid Expansion Impacts on Insurance Coverage and Access to Care
This issue brief, which provides a literature review of the effects of Medicaid expansion, was first released in June 2016 and has been updated to include additional information and data from 2016. Specifically, the brief focuses on the effects of expansion on health coverage and access, affordability, financial security, and quality of care.
Did Consumers Respond to Changes in Gross Premiums or to Changes in Premiums Net of Tax Credits When Making Health Plan Choices in the 2016 ACA Marketplaces
This research brief explains analyses conducted to explore whether consumers responded to changes in net or gross premiums when making health plan choices in the 2016 ACA Marketplaces.
Effects of the Affordable Care Act on Safety Net Hospitals
This study examines the early effects of the ACA on 10 safety net hospitals, both in states that expanded income eligibility for Medicaid under the ACA and those that did not. This primarily qualitative research study, was conducted between September 2013 and March 2016.
National Health Service Corps: An Extended Analysis
This study continues the analysis of the National Health Service Corps (NHSC) begun in “Provider Retention in High Need Areas. Its objectives are to examine recent retention trends of NHSC program alumni in HPSAs (more frequent moves from “same HPSA” to any HPSA” than previous study); analyze the retention patterns of those NHSC participants who serve in Indian Health Service sites and compare them with that of all NHSC participants (retention in “same HPSA” and “any HPSA” similar to overall NHSC, and third examine the recruiting and retention effects of the program Estimates of recru
Report to Congress: Social Risk Factors and Performance Under Medicare's Value-Based Purchasing Programs
This report, mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014 or the IMPACT Act (P.L. 113-185), requires the Secretary, acting through the Assistant Secretary for Planning and Evaluation (ASPE), to conduct research on issues related to socioeconomic status (SES) in Medicare’s value-based payment programs. The term social risk factor is being used in lieu of the term SES based on the January 2016 National Academies of Sciences, Engineering, and Medicine’s report which recommended reframing as such.
Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace
This issue brief presents analysis of Qualified Health Plan (QHP) data in the individual market Marketplace for states that use the HealthCare.gov Marketplace platform and State-Based Marketplaces where data is available. It examines plan affordability in 2017 after taking into account premium tax credits and also examines the plan choices that new and returning consumers will have for 2017. This brief shows that the Affordable Care Act is continuing to promote affordability and choice in the Marketplace for plan year 2017.
Health Insurance Marketplace Enrollment Projections for 2017
This brief looks ahead to estimate how many individuals nationwide might select a Marketplace plan during the upcoming Open Enrollment period and how many – on average throughout 2017 – might have Marketplace coverage. By the end of open enrollment for 2017, we expect 13.8 million people to have selected a plan and we estimate that 11.4 million individuals will effectuate their enrollment on an average monthly basis over the course of 2017.
Rural Hospital Participation and Performance in Value-Based Purchasing and Other Delivery System Reform Initiatives
There are distinct challenges and opportunities for delivery system reform initiatives in rural hospitals. This report examines what is currently known about rural health and health care, in particular the hospital sector; examines the participation and performance of rural hospitals in delivery system reform efforts; and provides a discussion of potential enabling factors for and barriers to rural hospitals’ successful participation and performance in delivery system reform.
Impacts Of The Affordable Care Act's Medicaid Expansion On Insurance Coverage Aand Access To Care
This issue brief provides a literature review of the effects of Medicaid expansion, with a focus on the impacts of the ACA’s Medicaid expansion in 2014 and 2015. Specifically, the brief focuses on the effects of expansion on health coverage and access, affordability and quality of care.
Marketplace Premiums after Shopping, Switching, and Premium Tax Credits, 2015-2016
Health insurance rate information becomes available each spring as issuers file proposed rates with federal and state regulators. Rates then undergo review before being finalized in the fall, prior to the annual Health Insurance Marketplace Open Enrollment Period. Neither the proposed nor final rates offered by any individual issuer provide a reliable basis for predicting what typical Marketplace consumers will pay in the following year.
Health Care Spending Growth and Federal Policy
In this Issue Brief, we examine spending growth through 2014, the first year the Affordable Care Act’s coverage provisions were in effect, and 2015, where possible. We provide detailed cost growth trends for Medicare and the private insurance market. We also estimate the effect of recently introduced specialty drugs on current and future spending growth.
Plan Selections by ZIP Code and County in the Health Insurance Marketplace: March 2016
The dataset provides the total number of Qualified Health Plan selections by ZIP Code and county for the 38 states that use the HealthCare.gov platform, including the Federally-facilitated Marketplaces, State Partnership Marketplaces, and supported State-based Marketplaces, during the Marketplace’s third Open Enrollment Period (based on data for the period November 1, 2015 – February 1, 2016).
Health Insurance Marketplaces 2016 Open Enrollment Period: Final Enrollment Report
During the third open enrollment period, the Health Insurance Marketplaces (“the Marketplaces”) continue to play an important role in fulfilling one of the Affordable Care Act’s central goals: reducing the number of uninsured Americans by providing affordable, high-quality health insurance.
Medicare Part B Drugs: Pricing and Incentives
Medicare Part B covers infusible and injectable drugs and biologics administered in physician offices and hospital outpatient departments; as well as certain other drugs required by law provided by suppliers such as pharmacies The Part B payment method provides weak incentives for physicians to consider value – that is choose the lowest cost therapy to effectively treat a patient. Moreover, the Medicare program has not implemented various value based practices typically used by commercial insurers and Part D sponsors for self-administered drugs.
Health Insurance Coverage and the Affordable Care Act, 2010 - 2016
This issue brief reviews the most recent survey and administrative information available about gains in health insurance coverage since the enactment of the Affordable Care Act (ACA) in 2010. We estimate that the provisions of the ACA have resulted in gains in health insurance coverage for 20.0 million adults through early 2016 (through February 22, 2016), a 2.4 million increase since our previous estimate in September 2015. These estimated health insurance coverage gains are shared broadly across population groups.
Community Health Workers: Roles and Opportunities in Health Care Delivery System Reform
Community Health Workers (CHWs) are an emerging group of health professionals that have recently drawn increased national attention because of their potential to deliver cost-effective, high quality, and culturally competent health services within team-based care models. The apparent benefits of integrating CHWs into health care teams seem to depend on context.
Addendum to the Health Insurance Marketplaces 2016 Open Enrollment Period: January Enrollment Report
This Addendum contains detailed State-level tables highlighting cumulative enrollment-related information for the Health Insurance Marketplaces (Marketplaces) during the the first part of the 2016 Open Enrollment period for all 50 states and the District of Columbia (11-1-15 to 12-26-15). These tables include data for These data are available for the 38 states that are using the HealthCare.gov platform for the 2016 coverage year (HealthCare.gov states), as well as for the 13 State-Based Marketplaces (SBMs) that are using their own Marketplace platforms for the 2016 coverage year.
Environmental Scan of Programs and Policies Addressing Health Disparities Among Rural Children in Poverty
About 12.9 million children live in rural communities, where they are more likely than their nonrural peers to experience health problems associated with their environment, their socioeconomic status, their own and their families’ health behaviors, and their access to quality clinical care. Despite the wealth of research regarding health disparities by income and race, there is limited information about policies and programs to address disparities among rural children. This environmental scan seeks to help fill this information gap.
Health Insurance Marketplace: Uninsured Populations Eligible to Enroll for 2016
By: Kenneth Finegold, Kelsey Avery, Bula Ghose, and Caryn Marks
How Many Individuals Might Have Marketplace Coverage at the End of 2016?
The Affordable Care Act (ACA) provides two main avenues for expanding health coverage: the Health Insurance Marketplaces (“Marketplaces”) and the law’s federal support for states that wish to expand their Medicaid programs. This brief estimates how many individuals nationwide might have Marketplace coverage after the upcoming Open Enrollment period (November 1, 2015–January 31, 2016) through the end of 2016.[1]
Competition and Choice in the Health Insurance Marketplaces, 2014-2015: Impact on Premiums
ASPE ISSUE BRIEF Steven Sheingold, Nguyen Nguyen, and Andre Chappel Disclaimer Persons with disabilities having problems accessing this document may call (202) 690-6870 for assistance.
2015 Plan Selections by County in the Health Insurance Marketplace
July 2015 (Updated) The dataset provides the total number of Qualified Health Plan selections by county for the 37 states that use the HealthCare.gov platform, including the Federally-facilitated Marketplace, State Partnership Marketplaces and supported State-based Marketplaces for the Marketplace open enrollment period from November 15, 2014 through February 15, 2015, including additional special enrollment period (SEP) activity reported through February 22, 2015.
Outreach and Enrollment for LGBT Individuals: Promising Practices from the Field
June 19, 2015 Tia Zeno, Katherine Warren, John Snyder
