Search Results
Report
Medication-assisted Treatment for Opioid Use Disorder in Rhode Island: Who Gets Treatment, and Does Treatment Improve Health Outcomes?
Since the early 2000s Rhode Island has been among the states hardest hit by the opioid crisis. In response, the state has made it a priority to expand access to medication-assisted treatment (MAT) for opioid use disorder (OUD), which refers to the use of the FDA-approved medications methadone, buprenorphine, and/or naltrexone in conjunction with behavioral therapy. MAT is strongly supported by scientific evidence and endorsed by US public health officials and yet fails to reach many OUD patients. Using administrative data covering medical treatments and selected health outcomes for more than ...
Briefing
College Towns and COVID-19: The Impact on New England
The abrupt closing of college campuses this spring due to the spread of COVID-19 upended the lives of students and their families and disrupted the higher education sector. The impact of these closures and the questions of whether and how to reopen campuses this fall have been widely discussed. Less attention has been paid to the potential consequences for the local economies of the cities and towns that depend heavily on higher education. This issue is particularly important in New England, where in many communities, colleges and universities are among the largest employers and make an ...
Briefing
Aging and declining populations in northern New England: is there a role for immigration?
In hundreds of communities across northern New England, the population is aging rapidly and becoming smaller. The entire country is aging, but northern New England stands out: Among the populations of all US states, those of Maine, New Hampshire, and Vermont have the top-three highest median ages, respectively. The situation is even more extreme in northern New England?s rural counties, where the populations of the smallest towns generally are substantially older than those of the rest of the region. These communities also have seen the slowest, or even negative, population growth over the ...
Briefing
The COVID-19 Pandemic’s Impact on Public Transportation Ridership and Revenues across New England
In New England and elsewhere, public transportation was among the many sectors immediately impacted by the COVID-19 pandemic. Essential workers and members of the labor force with no teleworking options and no alternate means of transportation continued to rely on public transit following the onset of the pandemic. However, with business closures, event cancellations, and social distancing regulations in effect, ridership dropped sharply, hampering transit systems’ ability to generate revenue. As of June 2021, ridership remained depressed despite the relaxation of restrictions and a general ...
Briefing
Recent Trends in Infrastructure Investment and Capacity in New England
Households and businesses throughout New England rely on roads, bridges, dams, sewers, drinking water systems, and other elements of public infrastructure daily. However, the region’s states and municipalities have long been acknowledged as spending less than much of the rest of country on these public capital assets. The Infrastructure Investment and Jobs Act of 2021 (IIJA) represents a massive and historic opportunity that will fund billions of dollars’ worth of repairs and improvements to public infrastructure across the region. The $1.2 trillion package contains $550 billion in new ...
Report
Why is state and local government capital spending lower in the New England states than in other U.S. states?
This report explores several hypotheses as to why state and local governments in New England have been spending less on capital investment than the national average, on a normalized basis. Census data show that state and local capital spending in all six New England states was well below the national average between 2000 and 2012, whether measured on a per capita basis, as a share of personal income, or as a share of state and local government spending. To explore why this is so, this report considers how capital spending has changed over time, how capital spending differs by state and across ...
Working Paper
Who Gets Medication-assisted Treatment for Opioid Use Disorder, and Does It Reduce Overdose Risk? Evidence from the Rhode Island All-payer Claims Database
This paper uses the all-payer claims database (APCD) for Rhode Island to study three questions about the use of medication-assisted treatment (MAT) for opioid use disorder (OUD): (1) Does MAT reduce the risk of opioid overdose; (2) are there systematic differences in the uptake of MAT by observable patient-level characteristics; and (3) how successful were federal policy changes implemented in 2016 that sought to promote increased use of buprenorphine, one of three medication options within MAT? Regarding the first question, we find that MAT as practiced in Rhode Island is associated with a ...
Report
Exploring causes of and responses to the opioid epidemic in New England
The opioid epidemic remains rampant in New England, where, from 2015 through 2017, more than 10,000 people died from opioid overdoses. In 2017, each of the six states experienced an overdose-death rate that was greater than the national average. Beyond causing a high number of deaths, the opioid epidemic is costing New England productive workers. People with the most severe problems stemming from opioid-use disorder tend to be in the 25?44 age group, but no one is immune. The epidemic affects people of every type?all ages and all races, men and women, residents of rural areas and of urban ...
Briefing
The Challenge of Declining K–12 Enrollment in Northern New England
COVID-related public health concerns and declining tax revenues raised or continue to raise important questions throughout the country about when and how to restart schools and how to fund them in the near term. For communities across northern New England, there are also fundamental, longer-term concerns over declines in the student population that will still confront districts well beyond the current academic year. In every county in New Hampshire, Maine, andVermont, the number of young residents has declined over the last two decades. Northern New England is not alone in facing this ...
Working Paper
Did the Affordable Care Act Affect Access to Medications for Opioid Use Disorder among the Already Insured? Evidence from the Rhode Island All-payer Claims Database
Previous research suggests that state Medicaid expansions implemented under the Patient Protection and Affordable Care Act (ACA) helped large numbers of patients suffering from opioid use disorder (OUD) gain access to life-saving medications, including buprenorphine. However, Medicaid expansions could have impeded access to care among individuals already enrolled in Medicaid, as new enrollees would have placed added demands on a limited supply of buprenorphine providers. Using a panel data set of medical claims from Rhode Island, we estimate the causal effects of the state’s January 2014 ...