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Author:Sullivan, Riley 

Report
Did the Medicaid Expansion Crowd Out Other Payment Sources for Medications for Opioid Use Disorder? Evidence from Rhode Island

Using information from the all-payer claims database for Rhode Island covering more than three-quarters of health insurance enrollees in the state from April 2011 through May 2019, this paper offers new measures of the association between the Medicaid expansion and the rate of receipt of buprenorphine and methadone for opioid use disorder (OUD). These robust measures adjust for the extent to which new Medicaid payments for these medications that started in 2014 crowded out payments from either non-Medicaid insurance or from non-insurance subsidies for the treatment of opioid abuse. We find ...
Current Policy Perspectives

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 ...
New England Public Policy Center Policy Reports , Paper 18-1

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. ...
New England Public Policy Center Research Report , Paper 17-1

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 ...
Working Papers , Paper 21-17

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 ...
New England Public Policy Center Regional Brief , Paper 19-2

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 ...
New England Public Policy Center Policy Reports , Paper 19-2

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 ...
New England Public Policy Center Regional Brief , Paper 19-1

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 ...
Current Policy Perspectives

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 ...
New England Public Policy Center Policy Reports , Paper 16-1

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 ...
New England Public Policy Center Policy Reports , Paper 17-1

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