News Archive

Hilltop Presents to Congressional Staff on Long-Term Services and Supports

Hilltop Senior Research Analyst Harriet L. Komisar participated in a meeting for congressional and federal staff hosted by the National Health Policy Forum on June 18, 2010. This meeting, the third of the Focus on Reform series providing an in-depth look at various components of the Patient Protection and Affordable Care Act (PPACA) and related implementation and operational issues, was entitled Long-Term Services and Supports (LTSS) and the CLASS Act. Komisar’s presentation discussed financing sources for LTSS. To view the presentation, click here.

Posted 06/21/10

Hilltop Presents at National Medicaid Conference

Hilltop Long-Term Supports and Services Director Cynthia H. Woodcock gave a presentation at the National Medicaid Congress pre-conference symposium entitled Managing Current and New Dual Eligibles on June 7, 2010. In the presentation, entitled Dual Eligibles in Nursing Facilities and Other Long-Term Care Settings, Woodcock discussed system coordination issues for dual eligibles in Maryland long-term care settings from a fiscal and service perspective and presented the opportunity for a coordinated care program; described New Mexico’s Coordination of Long-Term Services (CoLTS) program, which Hilltop helped New Mexico develop; and discussed whether coordinated long-term care was more efficient. To view the presentation, click here.

Posted 06/16/10

Hilltop Presents to Congressional Staff on Health Reform

Hilltop Executive Director Charles Milligan participated in a meeting for congressional and federal staff hosted by the National Health Policy Forum on May 7, 2010. This meeting, the first in a new Focus on Reform series providing an in-depth look at various components of the Patient Protection and Affordable Care Act (P.L. 111-148) and related implementation and operational issues, was entitled Medicaid Coverage Expansions. Milligan’s presentation discussed state implementation requirements as well as the opportunities and challenges the coverage expansions present for states. To view the presentation, click here. 

Posted 05/07/10

Hilltop to Provide Technical Assistance to Health Care Reform Coordinating Council

On March 24, 2010, Maryland Governor Martin O’Malley signed an Executive Order that created the Health Care Reform Coordinating Council (HCRCC) to make recommendations regarding Maryland’s implementation of the federal health reform legislation. The HCRCC, co-chaired by Lieutenant Governor Anthony Brown and Department of Health and Mental Hygiene Secretary John Colmers, has contracted with The Hilltop Institute to provide analysis and technical assistance throughout the HCRCC’s work, as well as to develop the two reports mandated by the Executive Order. To learn more about the HCRCC, click here.

Posted 04/28/10

Hilltop Completes Resource Mapping Project for the State of Rhode Island

The Hilltop Institute carried out a resource mapping project for the state of Rhode Island as part of the state’s efforts to create a more accessible system of long-term services and supports under their federal Real Choice Systems Transformation grant. Hilltop interviewed state agency staff on their perceptions of service gaps and barriers to accessing the system of long-term services and supports; conducted a survey of providers of long-term services and supports in the state about current and future capacity to serve Rhode Islanders; and constructed a rebalancing model for projecting utilization and expenditures for Medicaid long-term services and supports through 2030.

Click here to view Hilltop’s final report. Click here to view Hilltop’s presentation on the final report. Click here to view Hilltop’s presentation on the rebalancing model.

Posted 04/01/10

Hilltop Analyses Lead to Increased Access to Care

Hilltop’s work for the Maryland Health Services Cost Review Commission (HSCRC) analyzing Maryland hospitals’ financial assistance and debt collection policies informed the modification of a law enacted in 2009 that requires acute care hospitals to establish state-approved debt collection policies and provide medically necessary care to patients with family incomes below 150% of the federal poverty level (FPL). The legislation, taking effect October 1, 2010, applies the debt collection requirements to chronic care hospitals and requires hospitals to provide reduced-cost care to patients with family incomes below 500% of the FPL if they face financial hardship—medical debt incurred over a 12-month period that exceeds 25% of their income. This legislation will decrease the payment burden for those patients who are struggling financially, thus increasing access to care. Hilltop provided in-depth analyses of these policies and practices, provided consultation to the HSCRC work group that developed the recommendations for the Maryland legislature, and testified before the legislature to discuss its findings. To see the HSCRC report that includes Hilltop’s findings, click here.

Chuck Milligan Presents Paper at NGA State Summit on Health Reform

Hilltop Executive Director Chuck Milligan presented his paper, entitled Reshaping Medicaid, at the National Governors Association (NGA) State Summit on Health Reform on March 15, 2010, in Washington, DC. This invitational summit brought together four key stakeholders from each state—the Governor’s health policy advisor, the state’s Medicaid Director, the state’s Insurance Superintendant, and another individual selected at the state’s discretion—to explore and discuss health reform from the state perspective. The session, entitled Modernizing and Expanding Medicaid, focused on emerging opportunities and challenges in Medicaid, related to and independent of federal health reform. Following presentation of his paper, Milligan moderated a panel discussion that included Cindy Mann, Director of the Center for Medicaid and State Operations, Centers for Medicare and Medicaid Services; Carol Steckel, Commissioner of the Alabama Medicaid Agency; and Jason Helgerson, Medicaid Director, Wisconsin Department of Health Services. To view the conference proceedings, click here.

Hilltop Participates in 3rd Annual Medicaid Managed Care Summit

Hilltop Executive Director Charles J. Milligan, Jr., participated on a panel at the 3rd Annual Medicaid Managed Care Summit in Washington, DC on February 25, 2010. The summit examined policy changes, Health Care Reform, and funding opportunities, as well as explored strategic answers to the core challenges in managed care. The panel, entitled Establishing Coordinated LTSS [long-term supports and services] Programs: Solutions for Medicaid, States, and Consumers that Promote Improved Quality and Flexibility, brought together Milligan and other experts in long-term care who presented challenges and solutions for the largely unmanaged portions of state Medicaid budgets dealing with long-term care services from a fiscal, medical, and operations perspective with an emphasis on the perspective of seniors and people with disabilities. The discussion included: identifying the personal care needs of seniors and people with disabilities; public policy considerations for personal care that preserve independence and freedom; examples of successful State LTSS programs, including the New Mexico Coordination of Long-Term Services (CoLTS) Program, which Hilltop helped develop; and demonstrating how managed care can transform to coordinated LTSS. To view the panel slides, click here.  

Hilltop Presents Research Findings at SHARE Webinar

Hilltop Medicaid Policy Studies Director David Idala, MA, discussed Maryland's strategy for targeting public program enrollment efforts at a webinar hosted by the State Health Access Reform Evaluation (SHARE) on February 24, 2010, entitled Using Income Tax Information to Target Medicaid and CHIP Outreach. Idala’s presentation, entitled Maryland’s Kids First Act: Using Tax Forms to Identify Medicaid/CHIP-Eligible Children, discussed the findings of Hilltop’s evaluation and reviewed data collection, outreach strategies, impact on enrollment, and lessons learned. The evaluation was funded by SHARE, a national program of the Robert Wood Johnson Foundation®, with direction by the State Health Access Data Assistance Center at the University of Minnesota School of Public Health. To view the presentation, click here. To access the SHARE Issue Brief on the evaluation’s results, click here. To listen to the webinar, click here.

Hilltop Gives Legislative Testimony about Hospital Financial Assistance and Debt Collection

Hilltop Executive Director Charles Milligan testified before the Maryland State Senate Finance Committee on February 2, 2010, regarding proposed legislation to require chronic care hospitals to develop a financial assistance policy for providing free and reduced–cost care, as well as to establish debt collection policies and procedures. This legislation was developed as a result of recommendations made by a work group convened by the Health Services Cost Review Commission (HSCRC) to review hospital financial assistance and debt collection policies and practices. Hilltop provided in-depth analyses of these policies and practices to inform the group’s work. Milligan testified on a panel with Robert Murray, executive director, and Steve Ports, principal deputy director, of HSCRC. 

Hilltop Presents to State Officials on Status of Federal Health Reform

Hilltop Executive Director Charles Milligan gave a webinar for state officials on January 15, 2010. In this webinar, sponsored by the Robert Wood Johnson Foundation State Coverage Initiatives (SCI) program administered by AcademyHealth, Milligan discussed the current status of national health reform and its potential impact on the states. Milligan provided participants with the most up-to-date information on where things stand in the process, including the major areas of House-Senate agreement, the minor and major areas of House-Senate disagreement, and key implications for states. To view the presentation, click here.

Hilltop Assists New Mexico in Obtaining Medicaid Waiver to Continue its SCI Program

The Hilltop Institute assisted the New Mexico Human Services Department with preparing the application to the Centers for Medicare and Medicaid Services (CMS) for a Section 1115 Medicaid Demonstration project entitled the New Mexico State Coverage Insurance (SCI) Demonstration. This demonstration will  permit the state to continue coverage for non-pregnant childless adults aged 19 through 64, with incomes up to and including 200 percent of the federal poverty level (FPL). The program is designed to provide health care coverage to uninsured individuals who are unemployed, self-employed, or employed by a participating small business employer. The program was previously funded through a Section 1115 waiver under the Children’s Health Insurance Program (CHIP). When the program was reauthorized in 2009, a new waiver was necessary. Hilltop worked with New Mexico on the development of the waiver application, including performing the analysis to determine and establish budget neutrality.

Hilltop Presents to Maryland State Legislature

Hilltop Executive Director Charles Milligan participated on a panel that made a presentation before the Health and Government Operations Committee of the Maryland House of Delegates at a hearing on November 17, 2009, entitled Federal and State Trends in Hospital Oversight. The other presenters were Keith Hearle, President of Verité Healthcare Consulting, LLC, and Donna Folkemer, Group Director of the National Conference of State Legislatures. The presentation described national trends in tax-exempt hospital oversight; discussed state policy directions in financial protections for hospital customers; and presented two catalysts for state policymaking: insurance coverage rates and hospital behavior. Click here to view the presentation.

Hilltop Presents Findings of Medicaid Rate-Setting Methods Study to Maryland Department of Health and Mental Hygiene Long-Term Care Payment Advisory Committee

Hilltop Director of Long-Term Supports and Services Cynthia Woodcock presented findings from a Hilltop study directed by Senior Research Analyst Harriet Komisar, PhD, of community-based services in 11 states at the Maryland Department of Health and Mental Hygiene (DHMH) Long-Term Care Payment Advisory Committee (LTC PAC) meeting on November 12, 2009. Entitled Medicaid Rate-Setting Methods for Community Services in Selected States, the presentation described the community service system in Maryland, discussed the study, and presented the findings. The study focused on rate-setting methods for personal care, adult day care, and assisted living. Click here to see Hilltop’s presentation.

Hilltop Presents at National APPAM Research Conference

Hilltop Research Analyst Laura Spicer presented the findings of Hilltop’s evaluation of the New Mexico State Coverage Insurance (SCI) program at the Association for Public Policy Analysis and Management (APPAM) 31st annual research conference, Evidence-Based Policy Making in the Post-Bush/Clinton Era, on November 7, 2009, in Washington, D.C. Entitled Evaluation of Small Group Employer Participation in New Mexico's State Coverage Insurance (SCI) Program, the presentation was part of a panel on state health policy. In the presentation, Spicer gave an overview of the SCI program; presented results of the Hilltop surveys of employers who participated as well as those who inquired about but did not participate in the program; discussed implications for states that want to engage small businesses to participate in state coverage initiatives; and discussed implications for federal reform. To view the presentation, click here. In addition, on November 5, 2009, Hilltop Executive Director Charles Milligan was a discussant on a panel entitled Working with States to Develop Health Care Reform Initiatives: Research, Analysis, Politics, which addressed various aspects of health care reform at the state level.  

Hilltop Presents to Groups around the Country on Health Care Reform

This October, Hilltop Executive Director Charles Milligan has been making presentations to groups around the country on health care reform. On October 13, 2009, Milligan presented at an AcademyHealth-sponsored national teleconference. Over 100 lines called in, from Governor's offices, insurance departments, Medicaid and SCHIP agencies, and so on, representing over 40 states. On October 23, 2009, Milligan gave a presentation to the Louisiana Health Care Commission; on October 24, 2009, he gave a presentation to the National Association of Latino Elected and Appointed Officials (NALEO) Latino Legislative Summit on Health Disparities. In each presentation, Milligan described the health care reform process currently occurring in Congress, gave an update on the status of the Senate and House bills, and discussed two scenarios for how the process could conclude. For the Latino Legislative Summit, Milligan also discussed implications for states based on each scenario. To view the Summit presentation, which includes the implications for states, click here.

Hilltop Presents at NYIT Annual Aging and Society Conference

Hilltop Senior Research Analyst Harriet L. Komisar, Ph.D., gave a presentation at the New York Institute of Technology (NYIT) Center for Gerontology and Geriatrics Second Annual Conference on Aging and Society: “Reforming Long Term Care—Back to the Future” on October 7, 2009, in Westbury, New York. Komisar’s presentation, entitled You Can Run, But You Can’t Hide: Facing the Costs of Long-Term Care, provided an overview of long-term care (LTC), the population who utilizes it, and the common types of LTC assistance needed; discussed the costs of LTC from both an individual’s perspective and the national perspective; and made suggestions as to how the nation can prepare to meet the future needs of this increasing population. To view the presentation, click here.

Hilltop Presents on Non-Profit Hospitals at NASHP State Health Policy Conference

Hilltop Executive Director Charles Milligan gave a presentation at the National Association for State Health Policy’s (NASHP’s) 22nd Annual State Health Policy Conference on October 6, 2009 in Long Beach, California. In the presentation, entitled Nonprofit Hospitals: Earning Their Tax-Exempt Status Tying Medicaid Coverage to Tax Exemption, Milligan gave a brief history of the relationship between tax-exempt status and insurance coverage; discussed trends in insurance coverage; and suggested potential roles for tax-exempt hospitals in financing public insurance. To view the presentation, click here.

Findings from Hilltop Study of Using Tax Forms to Identify Medicaid/CHIP-Eligible Children Released

The State Health Access Reform Evaluation (SHARE) has just released an issue brief entitled Using Information from Income Tax Forms to Target Medicaid and Chip Outreach: Preliminary Results of the Maryland Kids First Act. The brief discusses the preliminary results of Hilltop’s evaluation of the outreach effort of Maryland’s Kids First Act. Maryland is one of the first states in the country to use information from state income tax forms to identify and enroll Medicaid and CHIP-eligible children. As a result of this innovative approach, SHARE commissioned the Maryland Department of Health and Mental Hygiene and its partner, The Hilltop Institute, to evaluate the outreach strategy. Hilltop Director of Medicaid Policy Studies David Idala, M. A., is principal investigator and research team leader. The brief identifies ten lessons learned from the experience so far, addressing issues such as data-sharing, health literacy, inclusion/exclusion criteria, tracking mechanisms, and the circumstances under which legislation is necessary in order to implement tax-based outreach. The project is funded by SHARE, a national program of the Robert Wood Johnson Foundation®, with direction by the State Health Access Data Assistance Center at the University of Minnesota School of Public Health. To view the brief, click here.

Hilltop Assists New Mexico in Obtaining Medicaid Waiver Renewal to Continue Mi Via Program

The Hilltop Institute assisted the New Mexico Human Services Department with preparing the renewal applications to the Centers for Medicare and Medicaid Services (CMS) for the Mi Via (My Way) self-directed waiver program. The program operates under two Section 1915(c) Medicaid waivers—one for individuals who might otherwise require care in a nursing home and the other for individuals with developmental disabilities. With Mi Via, participants can avoid institutionalization and remain at home or in the community. Participants manage their own budget and may choose from a wide array of home and community-based services, ranging from supports for community living to health and wellness supports. Hilltop worked with New Mexico on the initial design of Mi Via, originally launched in 2006. Mi Via is recognized as one of the most innovative Medicaid self-directed waiver programs in the country.

Hilltop Presents at NASHP Maximizing Enrollment for Kids Conference

Hilltop Executive Director Charles Milligan gave a panel presentation at the National Academy for State Health Policy’s Maximizing Enrollment for Kids Conference in Washington, D.C. on September 25, 2009. The panel, Streamlining Enrollment: One-Lane Highway to Express Lane, addressed the new CHIPRA Express Lane Eligibility option and early state experiences with automated enrollment strategies, including Maryland’s Kids First Initiative. Milligan’s presentation, entitled Maryland’s Kids First Act: Using Tax Forms to Identify Medicaid/SCHIP-Eligible Children, described the Act and its requirements; Maryland’s implementation; and the Hilltop evaluation of the outreach effort of using state income tax forms to identify and enroll uninsured but eligible children in Medicaid or CHIP. To view the presentation, click here.

Hilltop Presents at NASUA Membership Meeting

Hilltop Senior Research Analyst Ian Stockwell, M.A., gave a presentation entitled Data Integration in HCBS Program Development at the National Association of State Units on Aging 45th annual membership meeting in Denver, Colorado on September 23, 2009. The presentation discussed the potential that state policymakers now have to pull individual-level information together to form a complete picture of a program population through data integration. This method can provide a wealth of demographic and health status information for program building, as well as help predict service use, set appropriate individual budgets, and determine potential cost savings. Stockwell provided a brief overview of data sources currently available in most states; discussed the potential of new web-based information systems and provided a case study of a system currently in use; and discussed possible metrics and benchmarks, as well as some “best practices” on how to combine disparate datasets. To view the presentation, click here.

Hilltop Disseminates Research Findings on New Mexico’s SCI Program across the Country

Hilltop researchers have been actively presenting the findings of their study of employer participation in New Mexico’s State Coverage Insurance (SCI) program. The study, funded by the Robert Wood Johnson Foundation’s State Health Access Reform Evaluation (SHARE) program, determined what factors influence small business employer participation or non-participation in SCI, one of the state’s efforts to expand health coverage to low-income New Mexicans who are not eligible for Medicaid. Anna Sommers, PhD, a Hilltop senior research analyst and the project’s principal investigator, released the study’s findings at the 2009 AcademyHealth Annual Research Meeting in Chicago, Illinois on June 27 and June 30. Sommers participated on two panels: Early Results from the State Health Access Reform (SHARE) Program, and The Lab Reports: Evaluating States’ Actions to Expand Access & Coverage. On July 6, in the Pueblo of Laguna, New Mexico, Charles Milligan, JD, MPH, Hilltop’s executive director and an investigator on the project, included study results in his testimony before the New Mexico Legislative Health and Human Services Committee about the new Children’s Health Insurance Program Reauthorization Act (CHIPRA) and its impact on the SCI program. Changes in what CHIP funds can be used for have the potential to reduce funding for SCI, and the state is exploring its options in regard to sustaining the program. Most recently, on July 31, at the State Coverage Initiatives Annual Meeting in Albuquerque, New Mexico, Asher Mikow, MHA, a Hilltop research analyst and investigator on the project, and Mari Spaulding-Bynon, JD, Insure New Mexico! Bureau Chief at the New Mexico Human Services Department and co-principal investigator of the project, presented research results in a session entitled Research & Evaluation of State Reforms. Dissemination activities are also occurring within New Mexico, including presentations to program stakeholders, and other interested parties. A number of issue briefs are expected to be published in the fall by both the Robert Wood Johnson Foundation’s SHARE program and The Hilltop Institute. View the AcademyHealth presentation. View the handouts.

Hilltop Presents Luncheon Keynote at State Coverage Initiatives Annual Meeting

Hilltop Executive Director Charles Milligan, JD, MPH, was the luncheon keynote speaker at the AcademyHealth State Coverage Initiatives Annual Meeting on July 30, 2009 in Albuquerque, New Mexico. In his speech on health reform, Milligan outlined the current efforts to pass federal health reform and its potential impact on states and analyzed the federal-state relationship in the context of comprehensive reform. In addition, Milligan participated on a panel entitled Medicaid and the Children's Health Insurance Program: The Case for Increased Outreach and Enrollment Efforts, which highlighted the enhanced importance of state efforts to enroll eligible populations in public coverage programs. The session focused on ways to increase enrollment, and the increased incentives for doing so under Children's Health Insurance Program Authorization Act (CHIPRA), through examples such as express lane eligibility, facilitated enrollment, intensive application assistance, automated eligibility, etc. The session also examined Maryland's lessons learned in creating a system to identify and enroll uninsured children via income tax forms. Milligan's presentation, entitled Maryland's Kids First Act: Using Tax Forms to Identify Medicaid/SCHIP-Eligible Children, described the Kids First Act, Maryland's implementation activities, and discussed the initial results of Hilltop's study of the effectiveness of the state's outreach efforts. The study was commissioned by the Robert Wood Johnson Foundation's State Health Access Reform Evaluation (SHARE) program. To view the presentation, click here.

Hilltop Presents before Maryland Long-Term Care Payment Advisory Committee

As part of its role to provide consultation and technical assistance to the Maryland Department of Health and Mental Hygiene, Hilltop staff made two presentations before the Payment Advisory Committee Workgroup of the LTC Reform Committee on September 2, 2009. Charles J. Milligan, Jr., JD, Hilltop’s executive director, gave a presentation entitled, Nursing Facility Payment Policy: Comparing Maryland to Other States, in which he described findings from a Hilltop study that examined the Medicaid nursing facility (NF) payment systems of all 50 states and the District of Columbia, and then compared Maryland’s payment system to that in other states. To view this presentation, click here. Anthony M. Tucker, PhD, Hilltop’s director of special projects, gave a presentation entitled Resource Utilization Groups (RUGs), in which he described RUGs, the LTC minimum data set (MDS) as it is used to assign RUGs to NF residents, and Hilltop’s process to refine MDS data to examine patterns of care. Hilltop refined MDS data were also used to show the distribution of Maryland’s NF residents, as well as measures of length of NF stays, by RUG level and payor. To view this presentation and accompanying exhibits, click here.

Harriet Komisar Joins The Hilltop Institute

Harriet L. Komisar, PhD, a health economist with more than fifteen years of experience researching topics related to long-term care financing and health policy, has joined The Hilltop Institute as a senior research analyst in the Long-Term Supports and Services (LTSS) unit. In this capacity, she will assume a leadership role in developing and managing research and policy analysis related to LTSS for older adults and other persons with disabilities. Prior to joining Hilltop, Komisar was a research professor in the Health Policy Institute at Georgetown University. While at Georgetown, her research focused on assessing needs and access to long-term care for individuals eligible for both Medicare and Medicaid—dual eligibles—and developing and modeling alternatives for long-term care financing. Previously, Komisar was a principal analyst at the U.S. Congressional Budget Office, where she worked on issues related to Medicare's payment policies.

Hilltop Sponsors Symposium on the Effectiveness of Home and Community-Based Services

The Hilltop Institute sponsored the sixth Hilltop Symposium at which national experts discussed the measures and evidence to examine whether the expansion of home and community-based services (HCBS) has produced desired outcomes (quality, choice, cost, satisfaction, and safety) in the long term for older adults and persons with physical disabilities. The day was divided into four sessions and highlighted by a keynote address, a luncheon address, and concluding reflections. More than 130 policy makers, health services researchers, and health care practitioners from across the country, including the leading experts in the field, participated in the event. Click here to learn more.

Hilltop Partners with MIPAR to Win NIDRR Grant

The Hilltop Institute and its partner, the Maryland Institute for Policy Analysis and Research (MIPAR), at the University of Maryland, Baltimore County, have been awarded a National Institute on Disability and Rehabilitation Research (NIDRR) grant for a field-initiated project entitled Health Care Disparities in Access and Utilization among Individuals with Disabilities, scheduled to begin on October 1, 2009. The study will combine national survey data from the National Health Interview Survey (NHIS) and the Medical Expenditure Panel Survey (MEPS), pooling six years of data. Three measures of access and five measures of utilization will mirror those included in the series of Agency for Healthcare Research and Quality National Healthcare Disparities reports. The study’s analytic strategies will allow researchers to identify subpopulations with disabilities that are disparately impacted by system and individual characteristics, ‘doubly underserved’ individuals due to system-level and individual characteristics Researchers will identify factors which have the potential capacity to affect practice and policy, with the aim of elimination of disparities in health and function among individuals with disabilities. Annette Snyder, PhD, MSN, Hilltop’s director of clinical and quality management, is a co-investigator on the grant and will lead Hilltop’s project team. Adele Kirk, PhD, assistant professor of public policy, is also a co-investigator. Nancy Miller, PhD, associate professor of public policy, is the principal investigator and project leader.

Hilltop Presents on Evaluation of New Mexico's State Coverage Insurance Program at AcademyHealth Annual Research Meeting

Anna S. Sommers, PhD, a senior research analyst at The Hilltop Institute, participated on two panels at the AcademyHealth Annual Research meeting in Chicago, Illinois. The first panel occurred at the AcademyHealth State Health Research and Policy Interest Group Meeting, part of the pre-conference proceedings, on June 27 and was entitled Early Results from the State Health Access Reform (SHARE) Program. The second panel, entitled The Lab Reports: Evaluating States’ Actions to Expand Access & Coverage, occurred at the AcademyHealth Annual Research Meeting (ARM) on June 30. At both sessions, Sommers presented the findings from the Hilltop evaluation of small group employer participation in the New Mexico State Coverage Insurance (SCI) program. Sommers and her research team studied the factors that influence small employers’ decisions to participate in SCI, and found policy implications for both states and for federal reform. Policy implications for states are that there is a significant tradeoff between accessing federal dollars and employer recruitment; that some states use standards more transparent to employers; and that reaching the smallest firms may require different strategies. Implications for federal reform are that de-linking federal dollars from Medicaid/CHIP could allow use of more transparent and/or simplified eligibility standards; and that the pay-or-play federal mandate could assist states in engaging larger employers. The evaluation is partially funded by a grant from the Robert Wood Johnson Foundation State Health Access Reform (SHARE) Program. To view the presentation, Click here. To view the handout materials, Click here.

Hilltop to Collaborate with RWJF SHARE Program on Issue Brief on Use of Tax Forms to Identify Medicaid-Eligible Children

The Hilltop Institute’s Director of Medicaid Policy Studies David Idala made a panel presentation entitled Preliminary Findings of an Evaluation of the Maryland Kids First Act: The Use of Tax Forms to Identify Medicaid/SCHIP-Eligible Children at an AcademyHealth Special Interest Group (SIG) Meeting on June 27 in Chicago, Illinois. The presentation, part of the pre-conference proceedings of the AcademyHealth National Research Meeting, was based on an abstract that had been one of 33 high-quality abstracts submitted for peer review. Only two abstracts were chosen for this panel following the rigorous selection process. Idala is the principal investigator of a Robert Wood Johnson Foundation funded State Health Access Reform Evaluation (SHARE) project entitled Evaluating the Success of Maryland’s Kids First Act Outreach at Identifying and Enrolling Uninsured Eligible Children in Medicaid or SCHIP. As a result of the presentation, SHARE has invited Hilltop to collaborate on an issue brief regarding the preliminary findings of the study. To view the presentation, click here.

Hilltop Presents at Center for Health Care Strategies Meeting

Anthony M. Tucker, Ph.D., Director of Special Projects at The Hilltop Institute, gave a presentation at the kick-off meeting for the Transforming Care for Dual Eligibles initiative on June 17, 2009. This initiative, sponsored by the Center for Health Care Strategies, Inc. and funded by The Commonwealth Fund, will test innovative care models in eight states for people who are dually eligible for Medicare and Medicaid. In the session, entitled Medicare and Medicaid Data Analysis/Integration, Dr. Tucker focused on the integration and analysis of Medicare and Medicaid data; discussed his development and use of The Hilltop Crossover Framework-a new tool for the analysis of integrated care for dual eligibles; and discussed preliminary findings of his Robert Wood Johnson funded HCFO study of cross-payer effects for dual eligibles. To view the presentation, click here.

Hilltop Presents on Consumer-Directed Long-Term Care

Hilltop Executive Director Charles Milligan made a presentation before the District of Columbia (DC) Department of Health Care Finance on March 31, 2009. The presentation was part of the department’s Innovation in Health Policy Series. In the presentation, entitled Putting the Consumer First: Consumer Direction in Long-Term Care, Milligan painted a portrait of long-term care; discussed the aspects of consumer direction, showing examples from New Mexico’s Mi Via program, which Hilltop helped develop; and discussed the functions and competencies that are necessary to develop and implement a successful consumer-directed long-term care program. To view the presentation, click here.

Hilltop Presents at Medicaid Managed Care Summit

The Hilltop Institute’s executive director, Charles Milligan, made a presentation at the 2nd Annual Medicaid Managed Care Summit on February 25, 2009. The presentation, entitled New Mexico’s Coordinated Long-Term Services (CoLTS) Program, was part of a track concerning SNPs (Special Needs Plans) and Integrating Medicaid and Medicare. Milligan painted a portrait of dual eligibles (persons dually eligible for Medicare and Medicaid), painted a portrait of long-term care, and discussed New Mexico’s approach to coordinate services for this population, their CoLTS program. This program, which Hilltop helped New Mexico develop, seeks to: promote community-based services (CBS) by diverting or shortening nursing home stays; promote flexible benefit design to achieve new CBS models; improve quality through coordination of Medicare and Medicaid; and achieve financial savings by aligning Medicare and Medicaid incentives. To view the presentation, click here.

Hilltop Assists HSCRC in Their Review of Hospital Debt Collection Practices

The Hilltop Institute and its subcontractor, Verité Healthcare Consulting, LLC, synthesized and analyzed the financial assistance and credit and collection policies of all 47 of Maryland’s hospitals to assist the Maryland Health Services Cost Review Commission (HSCRC) in their response to Governor O’Malley’s request that the HSCRC perform a thorough review of hospital debt collection practices. The purpose of the analysis was to determine: if a general consensus exists among Maryland’s hospitals on various key aspects of the policies; if the financial assistance policies comply with the voluntary guidelines established by the Maryland Hospital Association (MHA) as a minimum expectation for hospitals; and if such policies in Maryland are in accord with national trends and perspectives. Hilltop’s findings were incorporated in the HSCRC report, which was released on February 13, 2009. To view the Baltimore Sun news articles, click below.
- In their debt
- Their day in court
- Loose rules

Cynthia Boddie-Willis Joins The Hilltop Institute

The Hilltop Institute is pleased to announce the addition of Cynthia Boddie-Willis, MD, MPH, as director of the newly reorganized Acute Care Policy and Research Unit. In this position, she will manage Hilltop’s initiatives in acute care policy, clinical and quality management, and research. Under her direction, Hilltop will continue to provide assistance to MCOs, state health agencies, local health departments, and other health care organizations in implementing Medicaid managed care programs; monitoring MCO performance; analyzing service utilization; identifying access barriers; evaluating the quality, affordability, and sustainability of publicly funded healthcare services; analyzing the administrative efficiency for health programs and systems; and informing health policy development. Her main research interest is in health disparities, a prominent theme of Hilltop’s work. Dr. Boddie-Willis was formerly Director of the Division of Health Promotion and Disease Prevention at the Massachusetts Department of Public Health, where she had oversight of the program development, implementation, and evaluation of health communications, health and the built environment, nutrition, physical activity, chronic disease prevention and management, healthy aging, health and disability, women’s health, and men’s health. In addition, she was a practicing physician at a federally qualified community health center, and hopes to continue to practice in Maryland. She comes to Hilltop with over 30 years of experience addressing the health care needs of vulnerable populations.

Hilltop Presents Integrated Managed Long-Term Care Approaches to Michigan Policymakers

The Hilltop Institute’s executive director, Charles Milligan, made a presentation to Michigan policymakers at an informational forum on December 11, 2008. In the presentation, entitled Integrated Managed Long-Term Care, Milligan gave a description of dual eligibles (persons eligible to receive both Medicare and Medicaid) and of long-term care; discussed various approaches to managed long-term care; described New Mexico’s approach, including their Coordination of Long-Term Services (COLTS) program, which Hilltop helped develop; and discussed Michigan’s challenges and opportunities for developing integrated managed long-term care. To view the presentation, click here.

Hilltop to Collaborate with Maryland on State Health Access Reform Evaluation

The Hilltop Institute and the Maryland Department of Health and Mental Hygiene (DHMH) have been commissioned by the Robert Wood Johnson Foundation State Health Access Reform Evaluation (SHARE) Initiative to perform an evaluation of the Kids First Act. The Kids First Act is the first law in any state to utilize the income and household information reported on state income tax returns to target outreach efforts to children who may be eligible for Medicaid or SCHIP. This is SHARE’s first commission. Hilltop will perform the study, which will evaluate the success of the act’s outreach efforts. Study results should not only help Maryland reduce the number of uninsured children in the state, but also help inform policymakers in other states. Senior Research Analyst Cheryl Powell, MPP, at The Hilltop Institute, is the principal investigator for the project. She will lead Hilltop’s project team, which includes Senior Research Analyst Anna Sommers, PhD, and Urban Institute Consultant Stan Dorn, JD. DHMH Office of Eligibility Services Director Cheryl Camillo, MPA, is co-principal investigator.

Hilltop Presents Non-Emergency Medical Transportation (NEMT) Study at Maryland Transportation Conference

Cheryl Powell, senior research analyst at The Hilltop Institute, gave a presentation for the Transportation Association of Maryland’s 20th Annual Fall Conference, Reaching, Teaching, and Serving…Our 20 Year Journey, on October 20 and 21. In the presentation, entitled Maryland Medicaid Non-Emergency Medical Transportation Study, Powell described the study—which evaluated the feasibility of creating a uniform statewide NEMT program in Maryland; any potential cost savings or potential for quality improvement; and the potential impact of the creation of such a program on local health departments—and discussed its findings. Hilltop conducted the study, which was mandated by House Bill 235, on behalf of the Maryland Department of Health and Mental Hygiene. To view the presentation, click here.

Hilltop Wins Contract to Map Rhode Island’s Long-Term Care Resources

The Hilltop Institute has won a contract from the New England States Consortium Systems Organization for Real Choices Long-Term Care Resource Mapping in the state of Rhode Island. Hilltop’s work will inform the state’s policy making by providing comprehensive information on Rhode Island’s current and projected population requiring publicly-financed long-term supports and services, the state’s institutional capacity, and the availability of community supports and services across the state. The project will also produce a tool for modeling the effects of various options for rebalancing state spending between institutional and home- and community-based services.

Hilltop Presents at National Home- and Community-Based Services Conference

The Hilltop Institute’s Director of Long-Term Supports and Services, Cynthia H. Woodcock, and Manager of Health Services Research, Al Adamson, presented a workshop on September 29, 2008, in Boston, at The Spirit of Independence: 24th National Home and Community Based Services Conference, convened by the National Association of State Units on Aging. In the workshop, entitled A Methodology for Projecting a State's Long-Term Care Costs, they discussed the methodology that Hilltop developed to project long-term care costs in Maryland for 2010, 2020, and 2030; discussed how other states could use that methodology to project future spending; and offered guidelines on how states could facilitate change in their long-term care systems. To view the presentation, click here. To view the full report, click here.

Hilltop Participates in Heritage Foundation Forum

The Hilltop Institute’s executive director, Charles Milligan, was an expert witness in an invitational forum hosted by The Heritage Foundation, on September 24, 2008, that explored innovative models for states’ reform of Medicaid programs and other vehicles for long-term care, paying particular attention to the concerns of the elderly and disabled. Entitled Workable Solutions for Long-Term Care, the forum simulated a Congressional hearing, in which health policy experts presented testimony and then fielded questions from a panel of distinguished members. Milligan presented in the session entitled Private Sector Models in the Context of Medicaid Reform, and focused on emerging opportunities to align Medicare and Medicaid payments and incentives. The goal of this alignment would be to reform Medicaid (and Medicare) to facilitate: the improvement of hospital discharge planning in a way that might avoid or reduce Medicaid-paid nursing facility stays; the improvement of the quality of long-term care services in a way that might avoid unnecessary Medicare-paid hospital admissions and emergency room use; and the promotion of greater flexibility in benefit delivery. To view Milligan’s testimony, click here.

Hilltop Collaborates with New Mexico in Development of New Coordinated Long-Term Services Program

The Hilltop Institute collaborated with the New Mexico Human Services Department in the development of a new coordinated long-term services program that has just received federal approval. The program will serve an estimated 38,000 Medicaid beneficiaries statewide, the vast majority of whom are enrolled in both Medicare and Medicaid ("dual eligibles"). The enrollees who are not dual eligibles will meet a nursing facility level of care even though many are already served in the community. Known as the Coordination of Long-Term Services (COLTS) Program, New Mexico's model will operate under a Section 1915(b)(c) waiver from the Centers for Medicare and Medicaid Services (CMS), and the state will contract with two managed care organizations (MCOs) that are also Medicare Advantage Special Needs Plans. The state has two major goals in COLTS: to coordinate Medicare and Medicaid services by contracting with MCOs that may serve the beneficiaries in both programs, and to coordinate the full array of Medicaid services in order to promote community-based services where appropriate for the given beneficiary. The program will be implemented on a statewide basis over the next 11 months. Hilltop has been working with New Mexico over the past three years to design the program, develop the waivers, and advise the state on the capitated rate structure.

Hilltop Presents at Colorado’s Centennial Care Choices Program Panel

The Hilltop Institute’s executive director, Chuck Milligan, gave a presentation on benefit design on August 4, 2008, before the Colorado Centennial Care Choices Program Panel, a governor-appointed expert panel charged with gathering information on the design, benefits, and costs of a Value Benefit Plan for the people of Colorado. Milligan discussed the concept of minimum benefits (a state’s determination of what constitutes “being insured”) and policy implications, such as the balance between a given state’s determination of where to strike a balance between its role to protect its citizens, and its role to respect individual liberty/autonomy to purchase services in the market; the balance between coverage by private insurance and government programs that wrap around those benefits; and the balance between covering more people with leaner benefits, or fewer people with more comprehensive benefits. Milligan then presented alternatives utilized by different states to provide benefits to their uninsured citizens.

Hilltop Hosts Fifth Symposium on Health Policy

The Hilltop Institute sponsored a day-long symposium to explore three major areas of policy innovation to improve access to and utilization of oral health care: integration of dental and medical service delivery; dental workforce issues; and health education and outreach strategies. The day was divided into four sessions and highlighted by a keynote address, a luncheon address, and concluding reflections. Over 130 policy makers, health services researchers, and health care practitioners from across the country, including the leading experts in the field, participated in the event. Click here to learn more.

Hilltop to Collaborate with New Mexico on State Health Reform Evaluation

The Hilltop Institute, in collaboration with the New Mexico Human Services Department, has received a grant to perform an evaluation of the New Mexico State Coverage Insurance program (SCI). The grant is one of 15 nationwide that was awarded through the Robert Wood Johnson Foundation State Health Access Reform Evaluation (SHARE) Initiative. The project will identify factors that have influenced employer participation in the New Mexico SCI program through surveys and analysis of administrative data. The project will not only benefit New Mexico, but will have national significance as well. Other states may face similar operational challenges related to combining public health insurance coverage with commercial-style insurance that requires employer contribution. New Mexico’s experience with its SCI program will provide lessons to other states that implement public/private partnerships or premium assistance programs requiring employer cooperation. This project is a state/university research partnership between New Mexico and Hilltop. Senior Research Analyst Anna Sommers, PhD, at The Hilltop Institute, is the principal investigator for the project. She will lead Hilltop’s project team, which includes Acute Care Policy Director Ann Volpel, MPA, Research Analyst Asher Mikow, MHA, Economic Analysis Director Hamid Fakhraei, PhD, and Research Assistant Laura Spicer. Insure New Mexico! Director Mari Spaulding-Bynon, JD, is co-principal investigator.

Cynthia Woodcock to Direct Hilltop’s Long-Term Supports and Services Unit

Cynthia H. Woodcock, M. B. A., has been named director of Hilltop’s Long-Term Supports and Services Unit. In this capacity, she will manage Hilltop's initiatives in long-term care policy and lead Hilltop's work on the development of home- and community-based services waiver programs and other integrated long-term care initiatives. In addition, she will continue to manage Hilltop's contract with the New Mexico Human Services Department, which has focused on launching a new self-directed waiver program and a Medicaid managed long-term care initiative. Under her direction, Hilltop is also assisting with implementation of Maryland's Money Follows the Person demonstration and carrying out an evaluation of New Jersey's federal Systems Transformation Grant in long-term care. She succeeds Wayne Smith, who retired last month, and has been with the unit since 2007. Woodcock joined Hilltop in 2004 as a senior research analyst, working with Hilltop's executive director on strategic planning and new business development.

Hilltop Receives Grant to Study the Economics of Antipsychotic Drug Use in Maryland’s Medicaid Population

The Hilltop Institute, in partnership with the UMBC Department of Public Policy, has received a two-year grant from NIH to study the economics of antipsychotic drug use in Maryland’s Medicaid population. The principal aim of the study is to analyze Maryland’s Medicaid data to identify cost and clinical correlates to specific antipsychotic drug choices of patients with schizophrenia. The analysis will review data spanning the period from 2002-2005, and earlier as feasible for select subpopulations. Dr. Tony Tucker from Hilltop will assist the project by merging Medicare and Medicaid records in order to assess clinical heterogeneity and costs, specifically for persons receiving benefits from both programs (dual eligibles). Senior Research Analyst Michael Abrams, MPH, the project’s co-investigator, will lead Hilltop’s team. Dr. David Salkever, Professor, Department of Public Policy, is the project’s principal investigator.

Hilltop Issues First Bulletin

The Hilltop Institute has issued its first electronic Bulletin about a report it prepared for the Maryland Community Health Resources Commission on School Based Health Centers. The Bulletin is the first formal venue that Hilltop has had for news releases. It will be used to periodically disseminate information about important news from Hilltop and about reports it produces. The Bulletin is sent electronically to the health services community. To view the Bulletin, click here.

Center Presents at NGA Center for Best Practices Workshop

The Center’s Executive Director, Chuck Milligan, participated in a panel discussion entitled How To Determine the Minimum Set of Required Benefits at a workshop conducted by the National Governors Association (NGA) Center for Best Practices on March 27, 2008. The workshop, Defining Benefit Packages in Health and Medicaid Reform, addressed how states could define and develop benefit packages which address the unique needs of their Medicaid beneficiaries. Milligan’s presentation discussed how different policy approaches affect a state’s determination of the minimum set of benefits that it mandates, as well as cost implications for the state and for the beneficiaries. To view the presentation, click here.

Center to Collaborate on Study of Payment for Psychiatric Services

The Center is collaborating with the Bloomberg School of Public Health at Johns Hopkins University and the UMBC Public Policy Department on an NIMH funded project to study the cost and quality implications of payment for psychiatric services. Diagnosis Related Groups (DRGs) are commonly used to pay inpatient hospitals. However, most of inpatient psychiatric care is paid per diem. The research seeks to improve psychiatric DRGs, with billing and supplemental information from medical records, so that they can be used for payment purposes. The study will also provide insight into hospital quality performance under per case payment. Dr. Hamid Fakhraei is leading the Center's research team.

Center Presents at State Coverage Initiatives National Meeting

The Center's Executive Director Chuck Milligan and Director of Acute Care Policy Ann Volpel participated in separate panel discussions at the National Meeting for State Coverage Initiatives that was held February 6-8, 2008 in Nashville, Tennessee. Milligan participated on a panel addressing emerging issues in the Medicaid and SCHIP programs and gave a presentation on recent directions in broad national policy, their implications for states, trends in state activities, and reforms approved by CMS under the Deficit Reduction Act and Section 1115 Waiver programs. Volpel participated on a panel discussing how states have attempted to address access and affordability in the small group market and gave a presentation on the two reports the Center completed on marketing state coverage programs. To view the reports, click here.

Center Presents Benefits of Coverage for Children to Idaho Legislative Committee

The Center's Executive Director, Chuck Milligan, presented information on the benefits of pursuing health insurance coverage for children and adolescents in Idaho on January 9 at the Cover Idaho Kids Coalition Meeting and Research Discussion. Funded by the Robert Wood Johnson State Coverage Initiatives program administered by AcademyHealth, these presentations gave an overview of research and literature that shows the positive relationship between health insurance coverage and good health outcomes. Milligan discussed the benefits of coverage to the child, the family, the community, and the system: that insurance coverage allows children and their families to access health care earlier, which can prevent more serious health problems and illnesses, thereby avoiding the need to use more expensive services, such as emergency rooms. Laura Spicer, a research assistant at the Center, reviewed the literature for the presentations.

Center receives funding for study entitled "Medicaid Long-Term Care Programs: Simulating Rate Setting and Cross-Payer Effects."

The Center, in partnership with the MD Department of Health and Mental Hygiene (DHMH), has received funding from the Robert Wood Johnson Foundation Changes in Health Care Financing and Organization (HCFO) program to conduct a two-year study on the interactive effects of Medicare- and Medicaid-provided services, particularly with respect to rate-setting for coordinated/integrated programs of care for those who are enrolled under both programs (duals). The Center’s Tony Tucker headed up the development of the grant application and will serve as a co-principal investigator. Judy Kasper of Johns Hopkins University will also serve as a co-investigator. Tricia Roddy at DHMH will serve as the formal project director, which will ensure that the grant funds will generate matching federal funds to conduct the study.

Center's Analysis Suggests Treatment for Heroin Addiction is Cost Effective

The Center conducted a study to determine if the expansion of buprenorphine as a strategy for battling opioid addiction is cost-effective. Commissioned by the Baltimore City Health Department and funded by the Annie E. Casey Foundation, the study used Medicaid data to examine health care service utilization differences between opioid addicts who were treated for their addiction versus those who went untreated, reviewed the literature, and estimated clinical and financial benefits and costs. The study's results supported the value and effectiveness of opioid maintenance therapy (OMT), and suggested that expanding treatment access has the potential to reduce both individual suffering and the overall societal burden associated with opioid dependence without increasing the cost of medical care. The research also indicated that expanding OMT has the potential to save the publicly financed health care system money by reducing heroin-associated morbidity in Medicaid and other insured and uninsured populations. Researchers estimated the cost savings and found that Baltimore City could save over $4,000,000.00 per year if utilization of OMT were expanded. To view the study's five reports, click here.

Chuck Milligan Presents at Conference about Medicare Special Needs Plans (SNPs)

Chuck Milligan gave a brief presentation on October 18 at the Center for Medicare Advocacy's conference, Medicare Advantage Special Needs Plans: A Beneficiary Perspective. The conference brought together beneficiary advocates, health policy advocates, researchers, SNP providers, Centers for Medicare and Medicaid Services (CMS) officials, and Congressional staff. The conference proceedings were anchored by three background papers, two of which were written by Chuck Milligan and Cynthia Woodcock. Invitees discussed and framed a set of recommendations to present to Congress and CMS. To view Chuck's presentation on connecting SNPs with state Medicaid programs, click here. To view the conference details and other materials, click here.

Center Disseminates Summary on Mental Health Symposium

The Center has produced a summary for the mental health symposium it hosted on June 12. This piece highlights the day's proceedings, including a summary of each speaker's presentation and overarching themes. Click here to read more on the events of Moving Forward: Designing and Financing Mental Health Services in an Era of Transformation.

Center Hosts Symposium on Mental Health Services

On June 12, 2007, the Center for Health Program Development and Management sponsored a symposium examining the evolving mental health system, how efforts to diffuse evidence-based practices and better coordinate services across agencies and branches of medicine are paying off, and the extent to which Medicaid managed care and other newer programming and financing strategies are helping transform the system. Click here for the program and presentations.

Center Co-Hosts Forum on Emergency Department Use

On June 7, 2007, the Center for Health Program Development and Management, together with the UMBC Department of Public Policy, sponsored a public policy forum examining emergency room services in Maryland. Click here for the program and presentations.

Ann Volpel to Direct Acute Care Policy Unit, March 22, 2007

Effective immediately, Ann Volpel has been selected to direct the Center's Acute Care Policy Unit. Ms. Volpel, who joined the Center as a research analyst in 2001, will now be responsible for directing the Center's work on Medicaid managed care policy, financing, and performance assessment, working with Maryland and other states. She will also manage the Center's work related to behavioral health and state coverage initiatives. She succeeds John O'Brien, who left the Center in January to join the Maryland Health Services Cost Review Commission.

Medicaid Commission Recommendations, November 28, 2006

The Center for Health Program Development and Management has been providing strategic and analytical support to the federal Medicaid Commission and assisting with preparation of the Commission's final report. On November 16, 2006, in Washington, Chuck Milligan, the Center's executive director, delivered this presentation as part of the discussion of the Commission's final report and recommendations:

Chairman's Mark and Proposed Amendments

http://www.aspe.hhs.gov/medicaid/nov06/Recommendations.pdf

Todd Eberly Receives Dissertation Award, September 8, 2006

Todd Eberly, a senior research analyst at the Center, has received the 2006 Annual Dissertation Award from the National Association of Schools of Public Affairs and Administration (NASPAA) for his dissertation entitled, Managing the Gap: Evaluating the Impact of Medicaid Managed Care on Service Use and Disparities in Health Care Access. Dr. Eberly examined whether racial and ethnic minorities experience disparate access to preventive health services in Maryland Medicaid and whether Maryland 's transition to Medicaid managed care had an impact on disparities. He received a Ph.D. in Public Policy from UMBC this past spring.

Click here for the Policy Brief on Dr. Eberly's Dissertation
Click here for Dr. Eberly's Dissertation.

Medicaid Commission Presentations, September 6, 2006

Chuck Milligan, executive director of the Center for Health Program Development and Management, delivered these presentations to the federal Medicaid Commission in Washington, D.C., on September 6, 2006:

Medicaid Systemswide Administration

Medicaid Reimbursement Policy

CPS Medicaid Undercount Update, August 31, 2006

A survey of Maryland Medicaid beneficiaries conducted by the Center in 2005 found a significant discrepancy in Medicaid enrollment between state records and the Current Population Survey (CPS) administered by the U.S. Census Bureau. To address the CPS undercount, the Center recommended that the Census Bureau alter the 2005 CPS survey instrument to include "Medical Assistance" as an alternative name for the Maryland Medicaid program.  This is the name by which Medicaid is known to most Maryland Medicaid enrollees. The 2005 CPS, released August 29, 2006, reports a 15 percent increase in Maryland Medicaid enrollees, along with a slight decline in the number of uninsured Marylanders. While the CPS still reports a significant undercount in Maryland Medicaid enrollees, the undercount is now in the range of the national average (20%-25%).  The increase in the number of Medicaid enrollees and the decrease in the number of uninsured are in line with estimates presented in the Center's report.

For the Center's report, The Maryland Current Population Survey Medicaid Undercount Study, click here.

To see the 2005 CPS released on August 29, 2006, click here.

AcademyHealth Presentations June 24-25, 2006

Center staff gave two presentations at the AcademyHealth 2006 Annual Research Meeting in Seattle , Washington . Todd Eberly, Ph.D., senior research analyst, delivered this presentation to the Child Health Services Research Meeting on June 24, 2006:

Evaluating the Impact of Medicaid Managed Care on Preventive Health Care Use by Children and Adolescents

Chuck Milligan, executive director of the Center, delivered this presentation at the session entitled, "Medicaid Reform: What's Working and What's Not?" on Sunday, June 25, 2006:

Medicaid Reform: Policy Roundtable Discussion

Keynote to Florida Medicaid Conference, June 1, 2006

Chuck Milligan delivered the keynote address to the 5 th Annual Medicaid Research Conference in Tallahassee , Florida , on June 1, 2006.

Medicaid Consumer-Directed Health Purchasing (as explained by Yogi Berra)

Health Insurance Symposium on June 13, 2006

The Center for Health Program Development and Management will host a one-day symposium on June 13, 2006, entitled The Changing Health Insurance Market: Implications for Public Policy and for State Government Purchasers. Click here for more information or contact Joyce Meyers at 410.455.6377 or jmeyers@hilltop.umbc.edu .

Medicaid Commission Presentation, May 17, 2006

Chuck Milligan, executive director of the Center for Health Program Development and Management, delivered this presentation to the federal Medicaid Commission in Dallas on May 17, 2006:

Who Are the Dual Eligibles?

Medicaid Commission Presentation, March 14-15, 2006

Chuck Milligan, executive director of the Center for Health Program Development and Management, delivered this presentation to the federal Medicaid Commission in Atlanta on March 14, 2006:

Long-Term Care: Overview and Summary of Reform Proposals

Medicaid Commission Presentation, January 25, 2006

Chuck Milligan, executive director of the Center for Health Program Development and Management, delivered this presentation to the federal Medicaid Commission at its meeting in Washington on January 25, 2006:

Summary of Medicaid Reform Proposals:  Eligibility Provisions

Axford Forum Coming to UMBC, January 18, 2006

On January 18, 2006, the Center will convene Ian Axford fellows and invited guests at UMBC for a one-day forum. Established in 1995, the Ian Axford Fellowships in Public Policy give outstanding American professionals opportunities to study, travel, and gain practical experience in public policy in New Zealand . Health care, the environment, taxes, ethnic diversity, and education are but a few of the topics that Axford fellows have investigated. The program has provided a unique opportunity to American policy professionals to engage in innovative thinking and explore diverse policy perspectives on a wide variety of topics.

This will be the first time that Axford fellows have come together. The agenda for the forum features presentations by the three 2005 Axford fellows who have recently returned to the United States.

• Dena Ringold of the World Bank examined how programs might be tailored to better address the range of disparities faced by indigenous peoples and other vulnerable populations, such as the 15 percent of New Zealanders who are also Maori.
  
• Nick Johnson of the Center on Budget and Policy Priorities studied New Zealand 's Working for Families program. He explored the relationship between fiscal and tax policy in meeting the needs of low-income populations while promoting efficient labor markets.
  
• John O'Brien of the Center for Health Program Development and Management at UMBC investigated the complexities of measuring and rewarding performance in health care delivery systems.

Click here to visit the Center's Axford Foum Page.

Reports by Axford fellows are available here.

Former Axford fellows will serve as responders, and the program will be placed in context with remarks by Robert Reischauer , President of The Urban Institute and former chair of the Ian Axford Fellowships selection committee; John Wood , New Zealand Ambassador to the United States; Annette Dixon , the World Bank's Director of Strategy and Operations for Europe and Central Asia Region; and Peter Watson , CEO of the Dwight Group and current chair of the Axford selection committee. Discussion among forum participants is expected to generate fresh insights and novel approaches to public policy that otherwise might not be considered.

Medicaid Commission Presentations, October 26 - 27, 2005

Chuck Milligan, executive director of the Center for Health Program Development and Management, delivered these presentations to the federal Medicaid Commission at its meeting in Washington on October 26-27, 2005:

Medicaid Eligible Populations
The Medicaid Acute Care Delivery System
The Medicaid Long-Term Care Delivery System
Quality and Information Technology in Medicaid
Medicaid Program Administration - Financing, IT, and Fraud and Abuse

New Issue Brief Coming Fall 2005

Academy Health has commissioned an issue brief entitled "Turning Medicaid Beneficiaries into Purchasers of Health Care: Critical Success Factors for Medicaid Consumer-Directed Health Purchasing." It will examine factors states should consider when launching Medicaid reforms such as those proposed in Florida, South Carolina, and West Virginia. The Center is collaborating with Academy Health's State Coverage Initiatives, a program of The Robert Wood Johnson Foundation, to prepare the issue brief.

Chuck Milligan Presents to Medicaid Commission, August 17, 2005

On August 17, 2005, Chuck Milligan , executive director of the Center for Health Program Development and Management, delivered a presentation to the Medicaid Commission. This presentation provided background information on the requirements and restrictions in the Medicaid program, and it touched on where flexibility does and does not presently exist.

To view Mr. Milligan's presentation, click here .

Chuck Milligan Testifies to Senate Finance Committee, June 28, 2005

On June 28, 2005, Chuck Milligan, executive director of the Center for Health Program Development and Management, testified to the Senate Finance Committee at the invitation of Senator Charles Grassley, committee chairman. Mr. Milligan discussed state Medicaid financing arrangements, such as intergovernmental transfer (IGT) and upper payment limit (UPL) arrangements that involve public hospitals and nursing facilities, as well as Medicaid school-based reimbursement. Click here for Mr. Milligan's written testimony and here for his oral testimony.

Michigan Medicaid: Relative Cost Effectiveness of Alternative Service Delivery Models, April 2005

In a Medicaid study required by Michigan's legislature, the Center evaluated whether capitated managed care involving multiple managed care organizations (MCO) is cost effective, when compared to three alternative delivery systems: fee-for-service, primary care case management, and a capitated managed care program involving a single statewide MCO. The Center's analysis concluded that the state of Michigan would save between $28 million and $129 million in state funds in FY 2006 when the current capitated program involving multiple MCOs is compared to all of the alternative delivery systems. The exact amount of savings that Michigan will achieve depends on the size of the managed care rate increase in FY 2006, and on which alternative delivery system is under consideration.

To review the report, click here.

Impact of the Medicare Prescription Drug Benefit on Home- and Community- Based Services Waiver Programs, April 2005

Home- and community-based services waiver programs enable many individuals dually eligible for Medicare and Medicaid to avoid nursing homes. But access to prescription drugs may be impeded when drug coverage is transferred from Medicaid to Medicare in January 2006, threatening the ability of dual eligibles to remain in the community. The Center examined the likely impact of the new Medicare drug benefit in Maryland and recommends federal policy remedies.

To review the Issue Brief, click here.

Strategies for Assessing Health Plan Performance on Chronic Diseases: Selecting Performance Indicators and Applying Health-Based Risk Adjustment, March 2005

As Medicaid managed care programs mature, states are looking to refine their methods for measuring and improving the performance of participating health plans. This report serves as a guide for Medicaid agencies who want to develop a performance measurement program using administrative data to evaluate the care provided to enrollees with chronic diseases. The report identifies potential performance indicators that are associated with improved medical outcomes and demonstrates the application of diagnosis-based risk adjustment to performance measurement by profiling six health plans.

To review the report, click here.

The Center for Health Program Development and Management Partners with the State of New Mexico

The Center is pleased to announce a new partnership with the New Mexico Human Services Department and New Mexico State University . The Center will assist New Mexico in developing and evaluating new Medicaid policies and programs. Initial work will focus on consumer-directed services and managed long-term care.