US Department of Health and Human Services, Centers for Medicare & Medicaid Services. (2014). Environmental scanning and program characteristics database: Task 5 ESPC final report. Baltimore, MD: Weinberg, D.
The Centers for Medicare & Medicaid Services (CMS) awarded the Environmental Scanning and Program Characteristics (ESPC) Database contract to IMPAQ International, LLC, using funds from American Recovery and Reinvestment Act (ARRA) of 2009. The ESPC contract required the development of two products: the ESPC Database and an analytic study using the information from the ESPC Database in conjunction with other data. This document is the final report for the contract.
The ESPC Database contains state-level environmental factors and program characteristics for Medicaid and the Children's Health Insurance Program (CHIP); it does not contain any person-level data. The database is intended to facilitate cross-state analyses by providing easy access to program characteristics and environmental factors that may result in variations in outcomes for the populations enrolled in Medicaid and CHIP. These variations must be controlled for in cross-state analyses in order to obtain unbiased estimates of the effects of policies and other variables of interest.
The ESPC Database contract included a task to conduct an analytic study that used the ESPC Database in combination with the MAX files to illustrate the value of the ESPC Database for interstate analysis. After discussing potential topics with CMS, researchers investigated the use of antipsychotic drugs among children in Medicaid.
An environmental scan of the topic of antipsychotic drug use highlighted two major areas of interest for researchers and policymakers. The first was the increasing use of second-generation antipsychotic drugs, also known as atypical antipsychotics, among children over the past 15 to 20 years. The second area was the large racial and ethnic disparities observed in antipsychotic drug utilization. Based on this information, researchers developed an empirical approach and an analytic data set to explore these questions. They investigated antipsychotic drug utilization rates and explored how utilization differs across states, over time, and by child characteristics such as age, gender, race and ethnicity, and eligibility group.