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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Hilltop provided this report to the Maryland Dental Action Coalition (MDAC) to examine the cost and policy implications of expanding adult dental coverage under Maryland Medicaid. Currently, Maryland is among 15 states that only cover emergency dental benefits for adults, while 17 states provide limited but broader coverage, and 15 states provide extensive coverage, according to the Center for Health Care Strategies. The only exceptions to this coverage limitation in Maryland are dental services for pregnant women and individuals enrolled in the Rare and Expensive Case Management program.

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On November 6, 2015, Hilltop Hospital Community Benefit Program Director Gayle D. Nelson, JD, MPH, gave this presentation and participated in a panel discussion at a session titled Health and Housing: Collaboration and Innovation at the 2015 National Housing Conference in New Orleans, LA. Nelson gave an overview of hospital community benefits; described how federal and state hospital community benefit laws and regulations can support communities addressing social determinates of health, including housing; and discussed how nonprofit tax-exempt hospitals and community development and affordable housing sectors might collaborate to develop healthy housing and communities.

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This issue brief, the twelfth in a series, addresses Hilltop’s latest update of the Community Benefit State Law Profiles to reflect new community benefit legislation enacted between January 1, 2015, and October 31, 2015. Just two states—Connecticut and North Carolina—enacted new community benefit legislation during this time. This brief discusses these changes, as well as community benefit bills in twelve states that were introduced but not enacted in 2015 in order to better understand current trends in legislative action.

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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 2013 annual evaluation of the HealthChoice program.

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