News & Bulletins Archive
Hilltop Senior Research Analyst Michael T. Abrams, MPH, is the first author and Hilltop Director of Health Services Policy and Research Cynthia Boddie-Willis, MD, MPH, is a co-author of an article titled Cervical Cancer Screening and Acute Care Visits Among Medicaid Enrollees With Mental and Substance Use Disorders that now is electronically available in pre-print version at the Psychiatric Services website. The article discusses the methodology and findings of a study that compared rates of cervical cancer screening and acute care (primary or gynecological) visits among women enrolled in Maryland’s Medicaid program in 2004-2005 with and without a diagnosis of psychosis, substance use disorder, bipolar disorder or mania, or depression. Researchers found that in Maryland Medicaid, the odds of cancer screening and related acute care visits were greater for women with major mental disorders compared with women in the control group. For women with substance use disorders, however, screening was reduced and acute care visits were similar compared with women in the control group. This work suggests that while women with serious mental disorders in Maryland Medicaid receive preventative somatic care on par with controls, those with substance use disorders (addictions) seem at higher risk for the absence of such care. To view the abstract and access the article, click here. For more information, contact Michael Abrams.
Hilltop Hospital Community Benefit Program Director Martha H. Somerville, JD, MPH, presented as part of a plenary town hall panel in a session titled Community Health Assessments: Opportunities for Collaboration at the National Network of Public Health Institutes (NNPHI) Annual Conference of May 23, 2012 in New Orleans, Louisiana. In her presentation, Partnerships for Community Needs Assessment−Community Benefits & Health Department Accreditation, Somerville outlined community benefit requirements under the Affordable Care Act (ACA) and related reporting requirements (Internal Revenue Service Form 990, Schedule H). The discussion focused on the ACA’s community health needs assessment requirement, how it can relate to public health department accreditation, and how Public Health Institutes can facilitate community partnerships of hospitals, health departments, and community-based organizations to conduct needs assessment and community health improvement planning, as well as develop initiatives to improve community health. To view the presentation, click here.
Hilltop Director of Special Studies Ian Stockwell, MA, gave a presentation at the Center for Health Care Strategies (CHCS) meeting, entitled State Planning for a High Performance Health System For Medicare/Medicaid Dual Eligibles and Implementing Innovations, which was held March 6 and 7, 2012 in Alexandria, Virginia. At the meeting, CHCS brought states together to focus on integrated care program development and improving the delivery of long-term services and supports (LTSS). In his presentation, Data vs. Dollars: The Interplay Between Analytical Methods and Rate Setting for Community Care, Stockwell discussed the use of predictive analytics and risk assessment to facilitate care in the community. In addition, he shared strategies for structuring reimbursement rates in a manner that encourages community-based care.
Hilltop Senior Research Analyst Michael Abrams, MPH, presented the findings of a study to elucidate coordination of care targets within Maryland’s Medicaid population of persons with substance use disorders. The presentation was made to Baltimore Substance Abuse Systems, Inc. (bSAS) leadership and their consultants on February 24th, 2012. BSAS, the public substance use authority in Baltimore City, is funding this work. The study uses a novel statistical technique – Latent Class Analysis (LCA) – to discern mutually exclusive and relatively homogenous subgroups of Medicaid enrollees with such disorders. This implementation of the LCA technique relies on Medicaid administrative data corresponding to demographic, enrollment category, utilization, state expenditure, and diagnostic information in order to identify 10 subgroups of persons with substance use disorders of various types. The results of this study will guide future work regarding the design of “medical homes” for such persons, with special focus on the full implementation of the Affordable Care Act. Abrams is the lead on this work, with substantial research and programming support by Policy Analyst Seung Ouk Kim, PhD, and Senior Programmer Jayne Miller, B.S. To view the full presentation with supporting tabulations and definitions, click here.
The Hilltop Institute’s Hospital Community Benefit Program has just released its third issue brief, entitled Hospital Community Benefits after the ACA: Partnerships for Community Health Improvement. The brief discusses a variety of options for collaboration in assessment, planning, priority setting, and implementation of health improvement initiatives; provides examples of diverse models already in place; and examines their impact on the communities in which they occur. To view the Bulletin, click here. To view the issue brief, click here.
The Hilltop Institute is pleased to announce that Martha H. Somerville, JD, MPH, is the new director of its Hospital Community Benefit Program. Somerville is a senior policy analyst at Hilltop and has devoted much of her time to the program since its inception in 2010. She is co-author of the program’s issue briefs and is actively involved in the program’s newsletter. To view the bulletin, click here.
Hilltop Director of Special Studies Ian Stockwell, MA, gave a poster presentation at the Gerontological Society of America’s (GSA’s) 64th Annual Scientific Meeting, which was held November 18 through 22, 2011, in Boston, Massachusetts. This conference brought together more than 4,000 of the brightest in the field of aging for a combined 500 symposia, paper, and poster presentations. To view Stockwell’s poster, which describes Hilltop’s analysis of Maryland’s Money Follows the Person program, click here.
Hilltop staff made two presentations at the 27th National Home and Community-Based Services (HCBS) Conference in Washington, DC, which took place from September 11 through 14, 2011.
Senior Policy Analyst Ian Stockwell, MA, gave a presentation with staff from the Maryland Department of Aging and the Maryland Department of Health and Mental Hygiene. This presentation, entitled Driving HCBS Innovation through Data and Metrics, discussed HCBS beginnings and momentum including advocacy and costs, HCBS waivers, Aging and Disability Resource Centers (ADRCs), and Money Follows the Person (MFP); data and metrics to build community-based services; and using metrics to move forward. Stockwell focused on Hilltop’s research on utilization and expenditures of both institutional services and HCBS in Maryland, as well as on the Quality of Life Survey Hilltop conducted, to discuss how metrics were used and how they can be used going forward.
Director of Long-Term Services and Supports Policy and Research Cynthia H. Woodcock gave a presentation entitled The Evaluation of the New Jersey Care Partner Support Pilot Program: Preliminary Findings. Woodcock gave an overview of the pilot program and data collection; described profiles of care managers, care recipients, and caregivers; and discussed the project’s status and the next steps of the evaluation.
Three research works were presented at the National Institute of Mental Health’s 21st Conference on Mental Health Services Research, held in Washington DC, on July 27-28, 2011. Improving Inpatient Psychiatric Payment Using Modified APR-DRGs (authors: Donald Steinwachs, David Salkever, Norbert Goldfield, Anthony Lehman, Michael Kaminsky, Michael Abrams, Elizabeth Skinner, Maureen Fahey, Hamid Fakhraei) was a presentation which summarized findings from a study of the costs associated with inpatient psychiatric events, as well as correlates to those costs which might be used to engineer case-rate billing procedures. Imminent Enrollment Lapses in Medicaid after Psychiatric Hospitalizations in Young Adults (authors: Maryann Davis, Michael Abrams, Lawrence Wissow, Eric Slade) was a poster presentation on work that reviewed factors associated with Medicaid disenrollment in the wake of discharges from an inpatient psychiatric event for persons age 18-26, which used classification and regression tree (CART) and probit analyses to focus on the strongest predictors of such disenrollment. Effects of Medicaid Lapses on Young Adults’ Use of Outpatient Services after Inpatient Stays, (authors: Eric Slade, Larry Wissow, Maryann Davis, Michael Abrams) was a slide presentation on a review of correlates between Medicaid enrollment discontinuities and outpatient mental health service use and among young adults age 18-26 who experienced a inpatient psychiatric event. For more information, contact Hilltop Senior Research Analyst Michael Abrams.
Donna Folkemer, MA, director of Hilltop’s Hospital Community Benefit Program, was a panelist at a recent public forum sponsored by the Centers for Disease Control and Prevention, entitled Best Practices for Community Health Needs Assessment and Implementation Strategy Development: A Review of Scientific Methods, Current Practices, and Future Potential, on July 12, 2011, in Atlanta, Georgia. Folkemer participated on the panel, entitled Reporting and Oversight: State Level Oversight, with Lois Johnson from the Massachusetts Office of the Attorney General and Gianfranco Pezzino from the Kansas Health Institute. Folkemer began by asking the audience to consider how best to create a public sector oversight role that can lead to desired outcomes for community health improvement. She noted that state approaches to reporting and oversight vary significantly and that there is not yet an evidence base to direct states as they define community benefit measures. She said that the Affordable Care Act is leading states to identify benchmarks of success as they design health insurance exchanges, health information technology systems, etc., stating that the same attention should be given to benchmarking in the community benefits arena. “Benchmarks are designed to measure the rate of change, and it will be important for states to find creative and practical ways to measure change in the practices of nonprofit hospitals to assure good community health outcomes,” Folkemer said.
The Hilltop Institute is pleased to announce the success of its fifth invitational symposium, Responding to Community Health Needs within the Framework of the Affordable Care Act (ACA), which convened on June 28, 2011. To learn more about the speakers, view the presentations, and see the agenda, click here. To view the bulletin, click here.
The Hilltop Institute had a visible presence at this year’s AcademyHealth ARM, held June 11-14 in Seattle, Washington.
On June 11, Hilltop and the Department of Health Management and Policy at Saint Louis University co-sponsored a Community Benefit preconference. Hilltop Hospital Community Benefit Program Director Donna Folkemer, MA, spoke about current policy challenges for states, discussing issues for states to help inform the interpretation and implementation of Section 9007 of the Affordable Care Act, which is the subject of the program’s second issue brief, Hospital Community Benefits after the ACA: Building on State Experience. To view the presentation, clickhere.
On June 12, Hilltop Senior Policy Analyst Karen E. Johnson, MS, gave a poster presentation entitled Using Propensity Score Matching Techniques to Establish Treatment/Control Groups to Assess Medicare and Medicaid Service Use, which was also authored by Hilltop Director of Special Research and Development Anthony M. Tucker, PhD, and UMBC Assistant Professor Yi Huang, PhD. The poster described the use of a propensity score matching methodology to identify comparison groups among Medicare-Medicaid beneficiaries who received Medicaid-paid long-term services and supports (LTSS) via home and community-based (HCBS) waivers versus those who did not receive LTSS. This matching technique was used to establish comparable treatment/control pairs for subsequent analysis of cross-payer effects of providing Medicaid-paid LTSS on Medicare acute care resource use, and could be used more generally to strengthen policy analyses that are based on observational and/or administrative data.
On June 12, Hilltop Policy Analyst Laura Spicer gave a presentation at a session on Addressing Cost and Affordability in Public Programs: Implications for the Affordable Care Act. Her presentation, entitled Evaluating Small Group Employer Participation in New Mexico’s SCI Program, discussed findings from a Hilltop study funded by the Robert Wood Johnson Foundation’s State Health Access Reform Evaluation (SHARE) initiative. The study identified factors associated with small group employer participation in New Mexico’s State Coverage Insurance (SCI) program.
On June 14, Hilltop Director of Medicaid Policy Studies David Idala, MA, gave a presentation at a session on outreach and enrollment that examined how states could reach newly eligible populations under the Affordable Care Act (ACA). His presentation, entitled Maryland’s Kids First Act: The Use of Tax Forms to Identify Medicaid/CHIP-Eligible Children, discussed the use of state income tax forms to identify children who are eligible for, but not enrolled in, Medicaid, and the lessons learned so far from the Maryland Kids First outreach initiative that could help states as they implement the ACA.
Finally, Hilltop Director of Long-Term Services and Supports Cynthia H. Woodcock, MBA, and Maryland Department of Health and Mental Hygiene Deputy Secretary of Finance and former Hilltop Executive Director Charles J. Milligan, Jr., JD, MPH, presented the keynote address, Rebalancing Long-Term Services and Supports: Progress to Date and a Research Agenda for the Future, at this year’s Long-Term Care Colloquium on June 14. Woodcock and Milligan presented highlights from their commissioned paper focusing on the success, to date, of rebalancing long-term care toward community settings and the implications of provisions in the Affordable Care Act for future rebalancing efforts.
The Hilltop Institute and the Department of Health Management and Policy at Saint Louis University are co-sponsoring a Community Benefit Preconference to the AcademyHealth Annual Research Meeting in Seattle, Washington, on June 11, 2011. The purpose of this preconference, entitled Moving Forward with Evidence-Based Policy and Practice, is to facilitate collaboration between health care delivery systems—particularly hospital community benefit programs—and the communities they serve. Hilltop Hospital Community Benefit Program Director Donna Folkemer, MA, will speak about policy challenges and opportunities for states as §9007 of the Affordable Care Act is implemented. This is the subject of the program’s second issue brief, Hospital Community Benefits after the ACA: Building on State Experience. The event is supported by the Robert Wood Johnson Foundation MATCH Program.
Hilltop Director of Long-Term Services and Supports Cynthia H. Woodcock, MBA, and Maryland Department of Health and Mental Hygiene Deputy Secretary of Health Care Financing and former Hilltop Executive Director Charles J. Milligan, Jr., JD, MPH, will present the keynote address at this year’s Long-Term Care Colloquium at the AcademyHealth Annual Research Meeting on June 14, 2011, in Seattle, Washington. In this colloquium, entitled Building Bridges: Making a Difference in Long-Term Care, Woodcock and Milligan will present highlights from their commissioned paper, focusing on the success, to date, of rebalancing long-term care toward community settings and the implications of provisions in the Affordable Care Act for future rebalancing efforts.
The Hilltop Institute’s Hospital Community Benefit Program has just released its first newsletter, Community Benefit Briefing. The newsletter is meant to assist state and local policymakers to understand and monitor hospital community benefit activities. This issue highlights the Catholic Health Association’s discussion draft of a new guide, Oregon House Bill 2392, a preconference to the AcademyHealth Annual Research Meeting, and the program’s second and third issue briefs. To view the newsletter, click here. To subscribe, click here.