Search Results
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 ...
Report
The criminal population in New England: records, convictions, and barriers to employment
The portion of the U.S. population with a criminal record has been receiving mounting attention in recent years. While there is a significant amount of data about the criminal population under supervision, there is very limited linked data identifying how most individuals move through the criminal justice system. By analyzing multiple national and state data sources, this report aims to identify the size of the New England population with a criminal record and to describe the broad demographic characteristics of this population. The report illustrates that the size of the population in the ...
Briefing
New England’s Lotteries: Trends in State Revenues and Player Spending
New England states, particularly Massachusetts and Rhode Island, exhibit remarkably high per capita spending on lottery purchases relative to the national average.
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 ...
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 ...
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 ...
Report
The Impact of Felony Larceny Thresholds on Crime in New England
Criminal justice reform has been a high-priority policy area in New England and the nation in recent years. States are generally seeking legislation that would help reintegrate ex-offenders into society while still prioritizing the welfare of all members of the public and the achievement of fiscal goals. The research findings presented in this report indicate that raising felony larceny thresholds—that is, increasing the dollar value of stolen property at or above which a larceny offense may be charged in court as a felony rather than a misdemeanor, a policy adopted by three New England ...
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
Can Treatment with Medications for Opioid Use Disorder Improve Employment Prospects? Evidence from Rhode Island Medicaid Enrollees
The nation’s long-standing crisis of opioid abuse intensified during the COVID-19 pandemic, with opioid-related deaths rising to nearly 81,000 in 2021, an increase of more than 60 percent from just two years earlier. Also during the pandemic, the labor force participation rate in the United States fell precipitously, and as of September 2022 it remained depressed by more than a full percentage point relative to its February 2020 level despite record numbers of job openings in 2021 and 2022. The unfortunate confluence of labor shortages and record-setting opioid mortality highlights the need ...
Briefing
Nursing Home Closures in New England: Impact on Long-Term Care, Labor Markets
The number of nursing homes in New England has declined steadily over the last decade, while the region’s population has grown older. This report looks at why nursing homes are closing—why they’re losing money—and how the closures, combined with the aging of the population, could affect the region’s infrastructure for long-term care. It also considers the closures’ potential impact on the region’s labor markets.