News & Bulletins Archive
The Maryland Health Care Reform Coordinating Council (HCRCC) released its final report on January 10, 2011. The report is the result of the HCRCC’s efforts since March 2010, when it was created by Maryland Governor Martin O’Malley to make recommendations regarding Maryland’s implementation of the Affordable Care Act (ACA). This final report sets forth a blueprint for Maryland’s implementation of health care reform and includes an overview of the ACA, with a description of the findings of the HCRCC, which were published in its interim report released in July 2010. It also: describes the already-established foundation for reform in Maryland; summarizes the work and process of the HCRCC; identifies the major challenges and opportunities presented by implementation; identifies the necessary investments to ensure success; and identifies 16 recommended short- and long-term action items on how federal reform can be implemented most effectively. The HCRCC was co-chaired by the Honorable Anthony G. Brown, Lieutenant Governor of Maryland, and John M. Colmers, Secretary of the Maryland Department of Health and Mental Hygiene. The lead staff for the HCRCC were Charles Milligan, Hilltop’s executive director, and Alice Burton, principal at Riverside Consulting, LLC. Beyond providing various forms of staff support, Hilltop’s researchers conducted an in-depth analysis of the provisions of the ACA and developed a financial model to project Maryland’s costs and savings associated with implementing health reform. To learn more about the HCRCC and view the interim and final reports, click here. To learn more about Hilltop’s financial model, contact Charles Milligan.
The Hilltop Institute’s Hospital Community Benefit Program released its first issue brief, entitled Hospital Community Benefits after the ACA: The Emerging Federal Framework. The brief provides historical background on federal hospital community benefit policy; outlines the new requirements described in the Affordable Care Act (ACA); and identifies new challenges and opportunities for state and federal decision makers as they begin to develop responses to the new federal requirements. The issue brief is the first in a series, funded by the Robert Wood Johnson Foundation, to be published over three years. To view the bulletin, click here. To view the issue brief, click here.
The Hilltop Institute at UMBC has just released a new issue brief entitled Overcoming Interagency Data-Sharing Barriers: Lessons from the Maryland Kids First Act that describes interagency data-sharing barriers that researchers and state officials encountered as they implemented and evaluated the Maryland Kids First Act outreach initiative. The brief provides an overview of strategies used to identify uninsured children who are eligible for public insurance programs; an update on Maryland’s tax-based outreach program, including a description of the interagency data-sharing barriers encountered and their resolution; a discussion of new data-sharing and outreach opportunities outlined in the Affordable Care Act (ACA); and a discussion of lessons for other states. To view the bulletin, click here. To view the issue brief, click here.
The findings of a Hilltop research project that identified factors associated with small group employer participation in New Mexico’s State Coverage Insurance (SCI) program have been published in an article in the December 9, 2010, online issue of HSR Journal. Entitled Small Group Employer Participation in New Mexico’s State Coverage Insurance Program: Lessons for Federal Reform, the article discusses administrative and cost issues that small employers considered when deciding whether to participate in the SCI program. It concludes that administrative and cost barriers to participation in SCI reported by employers suggest that the tax credit offered to small businesses under new federal provisions, which merely offsets the employer portion of premium, could be more effective if accompanied by additional supports to businesses. The study was partially funded by a grant to Hilltop and its partner, the New Mexico Human Services Department, from the Robert Wood Johnson Foundation State Health Access Reform Evaluation (SHARE). To view the article, click here. Findings of the study were also published in two issue briefs: one from Hilltop (click here) and one from SHARE (click here).
Hilltop Deputy Director Michael Nolin participated on a panel at the National Conference of State Legislatures (NCSL) Fiscal Leaders Seminar on December 9, 2010, in Phoenix, Arizona. The session, entitled State Fiscal Implications of Federal Health Reform, addressed what states are doing to examine the expected state fiscal implications of the Affordable Care Act. The panel discussed the areas where increased and decreased costs to Vermont and Maryland are anticipated and the assumptions and factors used to come to those conclusions. Nolin’s presentation discussed the financial analysis that Hilltop performed for the Maryland Health Care Reform Coordinating Council, which determined that Maryland would save $829 million in the next ten years by enacting federal health reform. To view the presentation, click here. To learn more about Hilltop’s financial modeling tool, contact Michael Nolin.
Hilltop Executive Director Charles Milligan gave a presentation before the Medicaid and CHIP Payment and Access Commission (MACPAC) at its monthly commission meeting on December 10, 2010, in Washington, DC. The presentation, entitled Medicaid and Medicare Resource Use For Dual Eligibles in Maryland, addressed the issue of coordinating long-term care for persons eligible for both Medicare and Medicaid (dual eligibles). In his presentation, Milligan discussed Hilltop’s research on Medicare/Medicaid cross-payer effects that found that Medicare and Medicaid financing do not align to promote home and community-based services. To view the presentation, click here. To learn more about Hilltop’s research on Medicare/Medicaid cross-payer effects, click here.
Hilltop Executive Director Charles J. Milligan was the luncheon keynote speaker for the University of Illinois Institute of Governmental and Public Affairs (IGPA) State Summit 2010: Reforming Medicaid in Illinois on December 7, 2010, in Champaign, Illinois. Milligan’s keynote address, entitled Transforming Medicaid in an Era of Health Reform: State Efforts to Thrive While Hoping to Survive, discussed economic trends and Medicaid; health reform; budget tools; and the changing state/federal relationship. The presentation deals with national trends and could be helpful to all states as they struggle with ensuring access to health services in a difficult economic environment. To view the presentation, click here.
Hilltop Director of Clinical and Quality Management Annette Snyder, PhD, and Senior Research Analyst Michael Abrams, MPH each made presentations at the 138th American Public Health Association (APHA) Annual Meeting held November 6 through 10, 2010, in Denver, Colorado. Snyder’s presentation, entitled The Impact of Selected Demographic, Mental Health and Geographic Measures on Discharge From Nursing Homes Among Working-Age Adults in Maryland, discussed a study that examined factors associated with discharge to the community for working-age adults admitted to Maryland nursing homes over a 5-year period. The study found that the strongest factors related to discharge to the community were an individual’s expressed preference for discharge and perceived support for community discharge. To view the presentation, click here. Abrams made a presentation entitled Cervical Cancer Screening and Gynecologic Visit Rates for Medicaid Enrollees with Mental and Substance Use Disorders. Abrams discussed the findings of a study that assessed PAP screening and gynecological visit rates experienced by women with non-affective psychosis versus other women with substance use disorder (SUD), bipolar or unipolar depression, or the absence of any of these illnesses (controls). The study found that women with psychosis or depression were more likely to receive PAP screening versus controls; and women with SUD with or without psychosis demonstrated reduced screening rates. In addition, Abrams presented a poster on another study, entitled Alternative and “Off-Label” Uses of Antipsychotic Medications in Medicaid, which used Medicaid administrative data from a single state (Maryland) and year (7/2000 to 6/2001) to estimate rates of alternative uses for antipsychotics. This study found a substantial alternative use of antipsychotics, especially for mood disorders and suggested distinctive patterns for the most experienced mental health care providers in alternative use of these medications.
The State Health Access Reform Evaluation (SHARE) has released an issue brief, entitled Participation in the New Mexico State Coverage Insurance (SCI) Program: Lessons from Enrollees. This is the second of two issue briefs that present results from a study of small business participation in SCI conducted by The Hilltop Institute. The study identifies the characteristics of non-sponsored enrollees in SCI and shares lessons learned about employer sponsorship of enrollees in SCI and similar public/private partnerships. To view the bulletin, click here.
Hilltop Executive Director Charles Milligan participated in a meeting for congressional and federal staff hosted by the National Health Policy Forum on October 29, 2010, in Washington, D.C. This meeting, the seventh of the Focus on Reform series providing an in-depth look at various components of the Affordable Care Act (ACA) and related implementation and operational issues, was entitled Medicaid Long-Term Services and Supports (LTSS) Provisions in PPACA. The session provided an overview of the Medicaid LTSS provisions enacted as part of the ACA, including the Community First Choice and Section 1915(i) state plan options; and the balancing incentive payments (BIP) and Money Follows the Person (MFP) programs, among others. Speakers described the provisions; strategies being employed by the Centers for Medicare & Medicaid Services (CMS) to assist states implement the various options, and opportunities and challenges facing states in implementation of the provisions. In his presentation, Milligan discussed the growth in Medicaid expenditures for LTSS; presented the results of a Hilltop study of Medicare/Medicaid cross-payer effects that found that Medicare and Medicaid financing do not align to promote home and community-based services (HCBS); described state and federal opportunities and barriers; and forecasted the take-up of LTSS options in the ACA. To view the presentation, click here.
The Hilltop Institute at UMBC is proud to announce the opening of its new Hospital Community Benefit Program. Made possible by the generous support of the Robert Wood Johnson Foundation and the Kresge Foundation, the program will be the first ever central resource created specifically for state and local policymakers to improve the reporting and evaluation of tax-exempt hospitals’ community benefit activities. The Hospital Community Benefit Program will be a resource to state and local health departments, hospital regulators, legislators, revenue collection and budgeting agencies, and hospitals, as each entity works to improve the transparency, comparability, fairness, and effectiveness of the community benefits delivered by tax-exempt hospitals. To view the bulletin, click here.
Hilltop Executive Director Charles Milligan was one of three experts who spoke at the UMBC Public Policy Forum entitled Health Care Reform: What Will It Mean to Maryland?, held October 22, 2010, in Baltimore, Maryland. In his presentation, entitled What Federal Health Care Reform Legislation Means to States, Milligan gave an overview of the new federal health reform legislation, the Affordable Care Act (ACA), and discussed its implications for states regarding Medicaid; exchanges; insurance-related issues; information technology; long-term services and supports; workforce issues; and preventive services and public health. Other speakers included Maryland Department of Health and Mental Hygiene Secretary John Colmers, who spoke about Maryland’s implementation plans and the Health Care Reform Coordinating Council, which he co-chairs; and Paul Fronstin, Senior Research Associate at the employee Benefit Research Institute, who spoke about the ACA’s implications for employers and employees. About 100 people from across Maryland were in attendance. Hilltop co-sponsored the forum with the UMBC Department of Public Policy, the Maryland Institute for Policy Analysis and Research, and the Annie E. Casey Foundation. To view Milligan’s presentation, click here. To view Colmers’ presentation, click here.
Hilltop Executive Director Charles Milligan gave a presentation at the closing general session of the American Health Insurance Plans (AHIP) Medicaid Conference on September 16, 2010, in Washington, DC. The session, entitled Opportunities for Medicare/Medicaid Integration: Serving Dual-Eligible Beneficiaries, addressed issues surrounding coordination of coverage and seamless integration of benefits for dually eligible individuals. Milligan’s presentation painted a portrait of dual eligibles, using Maryland as an example; gave an overview of cross-payer effects for dual eligibles and of Hilltop’s research on cross-payer effects for dual eligibles in Maryland; and discussed the study’s findings and policy implications. To view the presentation, click here.
This public policy forum will describe how Maryland plans to implement health care reform, with a focus on the impact of expanded coverage for working families. Speakers include Charles Milligan, Executive Director of The Hilltop Institute; John Colmers, Secretary of the Maryland Department of Health and Mental Hygiene; and Paul Fronstin, Senior Research Associate for the Employee Benefit Research Institute. Public Policy Professor Nancy Miller will moderate. To view the bulletin, click here.
The Maryland Health Care Reform Coordinating Council (HCRCC) released its Interim Report at a press conference in Baltimore on July 26, 2010. The report is the result of the HCRCC’s efforts since March 2010, when it was appointed by Maryland Governor Martin O’Malley to make recommendations regarding Maryland’s implementation of the recently enacted federal health reform legislation, the Patient Protection and Affordable Care Act (PPACA). The report includes: an overview of the federal law and its general implications for reform in Maryland; the role and mission of the HCRCC; the opportunities and challenges presented by reform implementation and the principles by which it must be guided; the state’s unique health care landscape and regulatory environment against which implementation decisions must be made; the projected fiscal impact of reform over the next decade; the workgroup process through which the HCRCC will formulate its recommendations on the decisions most critical to Maryland’s success; and a timeline for planning and key activities. The HCRCC is co-chaired by the Honorable Anthony G. Brown, Lieutenant Governor of Maryland, and John M. Colmers, Secretary of the Maryland Department of Health and Mental Hygiene. The HCRCC is staffed by Charles J. Milligan, The Hilltop Institute’s executive director, and Alice Burton, principal at Riverside Consulting, LLC. To support the HCRCC’s work, Hilltop researchers conducted an in-depth analysis of the provisions of PPACA and developed a financial model to project Maryland’s costs and savings associated with implementing health care reform. The model, based on current assumptions, predicts that health care reform could save Maryland an estimated $829 million in health care costs in the next decade. To learn more about the HCRCC and view the report, visit www.healthreform.maryland.gov/interimreport.html.