News & Bulletins Archive

Hilltop Senior Research Analyst and UMBC Public Policy PhD candidate Michael T. Abrams, MPH, has been awarded the 2015 Judith A. Shinogle Memorial Fellowship. The fellowship was established by Shinogle’s family in her memory to provide support for doctoral students committed to health policy research. Abrams was selected by a faculty committee in recognition of his outstanding scholarship and research in health policy. He will receive a monetary award and will give a presentation on his dissertation research, which focuses on the impact of news coverage on the dissemination of prescription drug warnings issued by the U.S. Food and Drug Administration. At Hilltop, Abrams directs and conducts quantitative and qualitative policy and health services research related to the brain and the behavioral health of Medicaid and other low-income populations.

Hilltop Hospital Community Benefit Program Director Gayle D. Nelson, JD, gave a presentation titled Federal Requirements for Tax-Exempt Hospitals: the IRS Final Rules at a Payers and Providers webinar titled The New Era: Hospital Community Benefits & Patient Financial Assistance on June 26, 2015. The webinar was attended by a national audience of state policymakers, community benefit directors of hospitals and health plans, financial officers, and providers. In her presentation, Nelson gave an overview of Affordable Care Act (ACA) §9007, “Additional Requirements for Charitable Hospitals,” which added I.R.C. §501(r) when it was enacted in 2010; gave a regulatory history from 2010 to the present; and discussed the Final Rules and their stipulations that were promulgated on December 31, 2014. For more information about this topic, contact Gayle Nelson.

View the slides. 

The Hilltop Institute’s Hospital Community Benefit Program has just released its eleventh issue brief: Hospital Community Benefits after the ACA: Leveraging Hospital Community Benefit Policy to Improve Community Health.

Read the News Alert. 

Hilltop staff made several presentations at the 2015 AcademyHealth Annual Research Meeting (ARM) held June 13 through June 15 in Minnesota. Senior Policy Analyst Shamis Mohamoud, MA, gave a podium presentation titled Evaluation of the Maryland Medicaid Chronic Health Homes Program on June 13 at the State Health Research and Policy Interest Group Meeting. On June 15, she presented a poster titled Prevalence of and Contributing Factors to Potentially Preventable Hospitalizations among Adult Maryland Medicaid Enrollees. Executive Director Cynthia H. Woodcock, MBA, presented three posters for Director of Special Studies Ian Stockwell, PhD: Using Data to Plan for and Implement Community First ChoiceNew Maryland Duals with Mental Health Conditions: Prior Medicare and Medicaid Resource Use, and The Effects of Managed Long-Term Services and Supports on Service Utilization and Expenditures: A Case Study. Senior Policy Analyst Charles Betley, MA, presented a poster titled Effects of Uninsurance on Tobacco Use Rates and Implications for New Medicaid Enrollment: Evidence from Maryland. Senior Policy Analyst Laura A. Spicer, MA, presented a poster titled Hospital Payment Reform in Maryland: Monitoring Medicaid Total Cost of Care. Senior Research Analyst Michael T. Abrams, MPH, presented two posters: Part D Utilization Management Barriers for Persons with Serious Mental Illness and Psychiatric Hospitalizations among Medicaid-Insured Youth. Lastly, Policy Analyst Carl Mueller, MS, presented a poster titled Dental Access among Children in Medicaid: Is Well Care or Ambulatory Service Utilization a Predictor of Preventive or Diagnostic Dental Service Utilization? To view the presentations, click on the titles.

Hilltop Executive Director Cynthia H. Woodcock was interviewed for and quoted in an article in the May-June 2015 issue of the Healthcare Journal of Little Rock titled The Cost of Caring by John W. Mitchell. The article focuses on the tension for nonprofit tax-exempt hospitals between requirements that they provide community benefits and the financial costs to them of providing expensive life-saving treatments, all while remaining financially viable. Woodcock discussed that under the Affordable Care Act and the new 501r Final Rule, hospital billing and collection practices have improved for patients, and that increases in coverage have afforded increased access to healthcare. The article also referenced the Hilltop Hospital Community Benefit Program’s State Law Profiles, which present a comprehensive analysis of each of the 50 state’s community benefit landscape as defined by its laws, regulations, tax exemptions, and, in some cases, policies and activities of state executive agencies. Click here to read the article.

New results generated by a team of UMBC researchers (from The Hilltop Institute, the Department of Public Policy, and MIPAR) recently revealed that persons with serious mental illness (SMI) who also have co-occurring substance use disorders (SUD) appear less likely to use or benefit from programs designed to help them find work and stay employed. Based on careful Maryland Medicaid and public mental health system data exploration from the mid-2000s when “place and train” supported employment (SE) programming efforts were expanded in the state, researchers found that SE uptake rates were on the order of 1.6 to 2.8 percent among those with SMI and SUD, whereas the analogous range was significantly higher at 4.1 to 4.7 percent for those with SMI only. Moreover, among persons receiving SE at some point, follow-up data into the years 2007-2010 indicated that rates of employment for the co-occurring group was only 19 percent compared to 29 percent for the SMI group without SUD. Future work will consider apparent antecedents to these disparities toward the development of strategies to increase SE uptake among persons with SMI and SUD. Additional work will look at uptake correlates and strategies more broadly.

This research was lead by Dr. David Salkever (UMBC Department of Public Policy) with funding support from the U.S. National Institute of Mental Health. Dr. Salkever presented these results at an April 2015 meeting in Barcelona, Spain. Hilltop Senior Research Analyst Michael Abrams, MPH, was a co-investigator on this work, and most of the analytic data set creation took place at Hilltop. For more information about this research, contact mabrams@hilltop.umbc.edu.

Presentation Citation: Salkever, D., Gibbons, B., Abrams, M., & Baier, K. (2015, April 15). Disparities in access to and effectiveness of evidence-based supported employment for persons with co-occurring serious mental illness (SMI) and substance use disorder (SUD): Evidence from a state-wide policy intervention. Fourth International Congress on Dual Disorders. Barcelona, Spain. View the presentation.

Hilltop is a partner with Benefits Data Trust (BDT), the Maryland Departments of Health and Mental Hygiene (DHMH) and Human Resources (DHR), and the Johns Hopkins University School of Nursing on a newly funded research grant from the Robert Wood Johnson Foundation to measure whether specific non-clinical interventions–such as enrollment into federally funded public benefit programs–improve health outcomes and reduce health care costs. The research team will study the impact of SNAP (food stamps) and home energy assistance on community-dwelling older adults eligible for both Medicare and Medicaid (dual-eligibles) residing in Maryland—a particularly vulnerable population with high health care costs. This research will provide a roadmap to understanding the true impact that safety net programs have on health care outcomes. For more information, contact Mike Nolin.

The Hilltop Institute’s Hospital Community Benefit Program has just released an update of its online resource, the Community Benefit State Law Profiles, and has published a new issue brief, Hospital Community Benefits after the ACA: State Law Changes and Promotion of Community Health.

Read the News Alert.

The Hilltop Institute has published an annual report of activities and accomplishments under the memorandum of understanding it has with the Maryland Department of Health and Mental Hygiene (DHMH) for fiscal year (FY) 2014 (July 1, 2013, through June 30, 2014). Hilltop’s interdisciplinary staff provided a wide range of services, including Medicaid program development and policy analysis; HealthChoice program support, evaluation, and financial analysis; long-term services and supports program development, policy analysis, and financial analytics; and data management and web-accessible database development. Hilltop has been providing services to DHMH for over 20 years, and this state/university partnership has received national acclaim. Read the report.

Hilltop Senior Research Analyst Michael T. Abrams, MPH, and Policy Analyst Carl H. Mueller, MS, are co-authors of a new study published in the Journal of Pediatrics titled Transcranial Doppler Screening of Medicaid-Insured Children with Sickle Cell Disease. The work was conducted in collaboration with researchers at Johns Hopkins and University of South Carolina medical schools under the direction of David G. Bundy, MD.The study found that letters to parents and doctors of children with sickle cell disease (SCD) did not succeed in increasing their use of a simple screening technique (transcranial Doppler imaging: TDI) for stroke risk, even as children with SCD are known to be at markedly heightened risk for stroke. The research, conducted largely at The Hilltop Institute, used Medicaid administrative data to identify a calendar year 2010-2011 cohort of individuals aged 2-16 years with SCD. Researchers measured 6-month post-letter TDI use in a group of 117 subjects whose parents and doctors were sent letters, and in a comparison group of 433 subjects who were not targeted by that mailing. Pre-intervention, annualized screening in the full SCD cohort (n=829) was just over 23 percent. Six-month follow-up on those who did not receive screening in the pre-intervention period was 7.2 percent in the group receiving the mailing and 8.6 percent in the comparison group. This difference was non-significant after adjusting for numerous covariates. Accordingly, this work reveals that a single mailing to parents and providers is not a sufficient method for increasing TDI use in youth with SCD. One important correlate that did emerge from this work is that specialist visits (e.g., to a hematologist) did significantly increase the use of TDI irrespective of the mailing. This incidental finding suggests that referral to a sickle cell specialist is more effective than referral for a specific procedure to address this serious illness, at least in terms of receiving important preventative screening. For more information, contact Hilltop team lead Michael Abrams (mabrams@hilltop.umbc.edu).

The full reference for this work is: Bundy, D. G., Abrams, M. T., Strouse, J. J., Mueller, C. H., Miller, M. R., & Casella, J. F. (2015). Transcranial Doppler screening of Medicaid-insured children with sickle cell disease. Journal of Pediatrics, 166(1), 188-90. doi: 10.1016/j.jpeds.2014.09.018.

The pubmed citation and abstract can be accessed here: http://www.ncbi.nlm.nih.gov/pubmed/25444529

On December 31, 2014, the Internal Revenue Service (IRS) published final rules implementing the “Additional Requirements for Charitable Hospitals” section of the Affordable Care Act (ACA). These rules relate to tax-exempt hospitals’ community health needs assessments (CHNAs); financial assistance policies (FAPs); and hospital charges, billing, and collection practices.

Read the Bulletin for a summary of the rules.

On December 5, 2014, Hilltop, together with the UMBC Department of Public Policy, the Maryland Institute for Policy Analysis and Research, CareFirst, and LifeBridge Health, sponsored a public policy forum describing how hospitals and health care providers in Maryland are adapting to the new all-payer model, and the likely effect on the populations that hospitals serve. Click here for the program and presentations.

Hilltop Senior Policy Analyst Stephanie Cannon-Jones, MPP, gave a presentation at the 25th Annual State of the States in Head Injury Conference on October 28, 2014 in Philadelphia, PA. Cannon-Jones’ presentation, Medicaid Expenditures for Persons with Brain Injury while Residing in a Nursing Facility, described the key findings of a study that examined Medicaid expenditures and service utilization patterns of Maryland Medicaid-eligible beneficiaries with a brain injury diagnosis who resided in nursing facilities.

On October 23, 2014, Hilltop held a special event to celebrate its 20th anniversary. Over the years, Hilltop has grown to become one of the most highly regarded university-based health policy research organizations in the country. The event featured Bruce Vladeck, PhD, as the keynote speaker.

Read the Bulletin.

Hilltop Hospital Community Benefit Program Director Gayle Nelson gave a presentation at the National Academy for State Health Policy’s 27th Annual State Health Policy Conference on October 8, 2014, in Atlanta, Georgia. In her presentation, titled Leveraging Hospital Community Benefit Requirements, Nelson discussed hospital community benefits and various approaches states could use to leverage them to improve population health.