The Hilltop Institute’s Community Benefit State Law Profiles (Profiles) present a comprehensive analysis of each state’s community benefit landscape as defined by its laws, regulations, tax exemptions, and, in some cases, policies and activities of state executive agencies. The Profiles organize these state-level legal frameworks by the major categories of federal community benefit requirements found in §9007 of the Affordable Care Act (ACA), §501(r) of the Internal Revenue Code. As state policymakers and community stakeholders assess their state’s community benefit landscape in the wake of national health reform, the Profiles provide a needed contextual basis for consideration of these policies against those of other states and federal community benefit benchmarks.

The Profiles were originally published in March 2013. Because states typically update laws during their annual legislative sessions, Hilltop methodically reviewed the community benefit laws of all 50 states twice in 2015 and once in 2016 to ensure that all legislative changes were identified. The first update, published January 2015, identifies changes that occurred between March 2013 and December 31, 2014. The second update, published December 2015, identifies changes that occurred between January 1, 2015, and October 31, 2015. This third update, published June 2016, identifies changes that occurred between November 1, 2015, and May 31, 2016.

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This report presents the findings of an assessment of the impact of diabetes on Maryland’s Medicaid program. The assessment focuses on adults aged 35 to 64 years enrolled in HealthChoice, Maryland’s Medicaid managed care program. The Hilltop Institute at the University of Maryland, Baltimore County (UMBC) conducted this assessment for MedChi, the Maryland State Medical Society, to provide a detailed view of the effects of diabetes diagnoses on the use of health care services and expenditures among adult HealthChoice enrollees.

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This chart book summarizes claims data for Medicaid beneficiaries in Mississippi using long-term services and supports (LTSS) data from calendar years (CYs) 2010 through 2014. It focuses on Mississippi’s five Medicaid waiver programs that provide home and community-based services (HCBS) to Medicaid-eligible individuals with low income and functional limitations. The waivers serve people who might otherwise require the services of a nursing facility, enabling them to return to or remain in the community.

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HealthChoice—Maryland’s statewide mandatory Medicaid managed care program—was implemented in 1997 under authority of Section 1115 of the Social Security Act. Since the inception of HealthChoice, the Maryland Department of Health has conducted five comprehensive evaluations of the program as part of the 1115 waiver renewals. Between waiver renewals, the Department completes an annual evaluation for HealthChoice stakeholders. This report is the 2014 annual evaluation of the HealthChoice program.

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On March 29, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a final rule on Medicaid and Children’s Health Insurance Programs; Mental Health Parity and Addiction Equity Act of 2008; the Application of Mental Health Parity Requirements to Coverage Offered by Medicaid Managed Care Organizations (MCOs), the Children’s Health Insurance Program (CHIP), and Alternative Benefit Plans (ABPs) (https://www.gpo.gov/fdsys/pkg/FR-2016-03-30/pdf/2016-06876.pdf). This rule provides new requirements for Medicaid and CHIP compliance with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equality Act of 2008 (MHPAEA) and the Affordable Care Act (ACA). Final MHPAEA regulations for group health insurance plans were issued in 2013. Much of this final rule extends the MHPAEA requirements for group health plans to Medicaid MCOs, CHIP, and ABPs, with exceptions and changes as applicable to address the unique aspects of state Medicaid mental health (MH) and substance use disorder (SUD) delivery systems. This document provides a high-level summary of the rule and highlights the changes to the proposed rule.

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Alcohol misuse has been identified as a major public health problem in the United States. However, although not yet widely adopted, alcohol screening and brief intervention (SBI) in the primary care setting has been shown to reduce problematic alcohol consumption.

In order to facilitate SBI for alcohol misuse, Research Circle Associates (RCA), a Maryland-based research firm, obtained a Small Business Technology Transfer (STTR) grant to develop a computerized SBI for use in the primary care setting. The Interventionaire© is a software system used to create and administer patient-based behavioral screening questionnaires and provide normative feedback to patients immediately upon completion of the questionnaire. Following successful proof-of-concept work in Phase I of the STTR, RCA contracted with The Hilltop Institute to conduct a qualitative analysis to address one specific aim of a larger Phase II implementation study: identify staff-perceived barriers to implementing the Interventionaire© in the primary care setting.

This report not only identifies staff-perceived barriers to implementing a computerized alcohol SBI tool in a primary care setting, but also identifies potential facilitators and explores anticipated advantages and disadvantages to implementation.

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At the request of the Maryland Department of Health and Mental Hygiene (DHMH), The Hilltop Institute conducted a series of analyses on the health care utilization of Maryland’s full-benefit Medicare-Medicaid dual-eligible beneficiaries. Together, these analyses provide an overview of how this population accesses health care services, the types of services being used, and where the services are provided.

This analysis explores utilization of inpatient services by “high utilizer” full-benefit dual-eligible beneficiaries, defined as those who had three or more inpatient stays during CY 2012. The report examines demographics and county of residence; providers serving this population; chronic conditions and most frequent diagnosis-related groups; and Medicare and Medicaid expenditures and service days.

Related publications: Maryland Full-Benefit Dual-Eligible Beneficiaries’ Use of Medicare and Medicaid Services Preceding and Following a Medicare Inpatient Stay, An Analysis of Selected Mental Health Conditions among Maryland Full-Benefit Dual-Eligible Beneficiaries, and The Maryland Dual-Eligible Beneficiaries Chart Book.

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At the request of the Maryland Department of Health and Mental Hygiene (DHMH), The Hilltop Institute conducted a series of analyses on the health care utilization of Maryland’s full-benefit Medicare-Medicaid dual-eligible beneficiaries. Together, these analyses provide an overview of how this population accesses health care services, the types of services being used, and where the services are provided.

This report examines full-benefit dual-eligible beneficiaries with mental health conditions in Maryland during calendar year (CY) 2012, including number and type of mental health conditions; demographics and county of residence; emergency department use; and Medicare and Medicaid expenditures and service days.

Related publications: Maryland Full-Benefit Dual-Eligible Beneficiaries’ Use of Medicare and Medicaid Services Preceding and Following a Medicare Inpatient Stay, Characteristics of Maryland Full-Benefit Dual-Eligible Beneficiaries with Three or More Inpatient Stays, and The Maryland Dual-Eligible Beneficiaries Chart Book.

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At the request of the Maryland Department of Health and Mental Hygiene (DHMH), The Hilltop Institute conducted a series of analyses on the health care utilization of Maryland’s full-benefit Medicare-Medicaid dual-eligible beneficiaries. Together, these analyses provide an overview of how this population accesses health care services, the types of services being used, and where the services are provided.

This report explores dual-eligible beneficiaries’ use of post-acute care (i.e., skilled nursing, inpatient rehabilitation, nursing facility services, hospice, and home health services) in the 30 days immediately following an inpatient stay, as well as their settings of care in the 7 days preceding an inpatient stay. In addition to pre- and post-inpatient settings, the report examines demographics, county of residence, and the most frequent diagnosis-related groups for the population studied.

Related publications: An Analysis of Selected Mental Health Conditions among Maryland Full-Benefit Dual-Eligible Beneficiaries, Characteristics of Maryland Full-Benefit Dual-Eligible Beneficiaries with Three or More Inpatient Stays, and The Maryland Dual-Eligible Beneficiaries Chart Book.

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The Maryland Dual-Eligible Beneficiaries Chart Book provides an overview of Maryland dual-eligible beneficiaries with breakdowns by benefit category, age, race, gender, and county of residence; the cost to Medicare and Medicaid of providing care to this population; and the prevalence and costs of chronic health conditions. The chart book is the most recent edition in Hilltop’s chart book series, which includes publications on Medicaid long-term services and supports in Maryland and Medicaid services for individuals with traumatic brain injury and autism.

Related publications: Maryland Full-Benefit Dual-Eligible Beneficiaries’ Use of Medicare and Medicaid Services Preceding and Following a Medicare Inpatient Stay, An Analysis of Selected Mental Health Conditions among Maryland Full-Benefit Dual-Eligible Beneficiaries, and Characteristics of Maryland Full-Benefit Dual-Eligible Beneficiaries with Three or More Inpatient Stays.

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