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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
The Medicaid Expansion and the Uptake of Medication-assisted Treatment for Opioid Use Disorder: Evidence from the Rhode Island All-payer Claims Database, 2012–2018
This article uses the all-payer claims database for the state of Rhode Island to assess recent progress in the state toward the goal of expanding access to medication-assisted treatment (MAT) for opioid use disorder (OUD). The analysis highlights the role played by the Affordable Care Act (ACA) and the associated Medicaid expansion in furthering that goal. Using measures that account for changes in health insurance enrollment, we find that the MAT rate per 100,000 enrollees in Rhode Island effectively doubled between 2012 and 2018, while the prevalence of OUD in the sample also doubled over ...
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 ...
Briefing
Declining access to health care in northern New England
Access to health care is a major concern across the northern New England states?Maine, New Hampshire, and Vermont?where rising operating costs and population loss threaten the stability of hospitals and other medical facilities that serve their surrounding rural communities. New analysis of financial data shows that many rural hospitals are operating at losses that are predictive of financial distress or even closure. Consequently, the communities served by these hospitals may be at risk of losing the benefits they provide to public health and the local economy. Addressing the financial ...
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 ...
Report
The fiscal impact of the opioid epidemic in the New England states
The rise in the abuse of?and addiction to?opioids and the rapid increase in the number of fatal overdoses in recent years have made the opioid epidemic a priority for local, state, and federal policymakers. Understanding the epidemic?s direct fiscal impact is key to acknowledging its scope and magnitude. While opioid abuse has many direct and indirect fiscal costs, few studies quantify them. This report assembles available data on the impact of opioid epidemic on criminal justice, treatment, and related health expenditures in the New England states. The research finds that state governments ...
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 ...
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 ...
Report
Reintegrating the ex-offender population in the U.S. labor market: lessons from the CORI Reform in Massachusetts
Policymakers have proposed and enacted policies that seek to limit the negative consequences that a criminal record imposes on ex-offenders, their families, and society at large. Some states have changed how criminal records are accessed and governed in the interest of removing unduly burdensome barriers to employment for some ex-offenders. Between 2010 and 2012, Massachusetts enacted the Criminal Offender Record Information (CORI) Reform, changing access guidelines for criminal records and preventing employers from inquiring about criminal history on an initial application for employment. ...