Practice Expense Data Collection and Methodology: Phase II Final Report.

Each year, Medicare allocates tens of billions of dollars for indirect practice expense (PE) across services on the basis of data from the Physician Practice Information (PPI) Survey, which reflects 2006 expenses. Because these data are not regularly updated, and because there have been significant changes in the U.S. economy and health care system since 2006, there are concerns that continued reliance on PPI Survey data might result in PE payments that do not accurately capture the resources that are typically required to provide services. In this final phase of a study on PE methodology, the authors address how the Centers for Medicare & Medicaid Services (CMS) might improve the methodology used in PE rate-setting, update data that inform PE rates, or both. The authors conclude that this information is best provided by a survey; therefore, they focus on the advantages and disadvantages of survey-based approaches. They also describe the use of a lean model survey instrument, as well as partnering with another agency to collect data. Finally, the authors describe a virtual town hall meeting held in June 2021 to give stakeholders an opportunity to provide feedback on PE data collection and rate-setting. The system of data and methods that CMS uses to support PE rate-setting is complex; thus, CMS must take into account a number of competing priorities when considering changes to the system. With this in mind, the authors offer a number of near- and longer-term recommendations.

Patterns and predictors of postsecondary re-enrollment in the acquisition of stackable credentials.

Using 15 years of student enrollment histories from administrative data spanning the 2004-05 through 2018-19 school years at all public colleges, universities, and technical/trade schools in the state of Ohio, we examine rates of re-enrollment in postsecondary education for individuals pursuing additional credentials following the receipt of a sub-baccalaureate certificate. We find that the majority of certificate recipients re-enroll to continue their progression toward stacking credentials. The likelihood of re-enrollment diminishes for certificate earners as they get further out from the term when their initial certificate was completed. Certificate earners re-enroll at an accelerated rate if they acquired their initial certificate at a community college, if they currently have low wages at their jobs, and following increases in local unemployment rates. Our findings lend support to sociological ideas about the role of institutional contexts, opportunity costs, and labor market opportunities in shaping non-traditional postsecondary pathways across the life course.

Aid after enrollment: Impacts of a statewide grant program at public two-year colleges.

Most students who begin at community colleges do not finish with a degree. The net price of college commonly shifts after enrollment, and there is little evidence on how these shifts affect two-year degree completion. This study provides evidence on the impacts of a private program that offered supplemental grant aid to students with demonstrated financial need, who were already enrolled at public two-year colleges in Wisconsin. An evaluation using a randomized control group and data from over 4,000 students in multiple cohorts, fails to confirm substantial increases in persistence or degree completion caused by the grant program. We highlight some features of implementation that added complexity and may have reduced the effectiveness of the grant program.