News & Bulletins Archive
Hilltop Executive Director Charles Milligan made a presentation before the District of Columbia (DC) Department of Health Care Finance on March 31, 2009. The presentation was part of the department’s Innovation in Health Policy Series. In the presentation, entitled Putting the Consumer First: Consumer Direction in Long-Term Care, Milligan painted a portrait of long-term care; discussed the aspects of consumer direction, showing examples from New Mexico’s Mi Via program, which Hilltop helped develop; and discussed the functions and competencies that are necessary to develop and implement a successful consumer-directed long-term care program. To view the presentation, click here.
Anthony M. Tucker, Ph.D., Director of Special Projects at The Hilltop Institute, gave a presentation at the kick-off meeting for the Transforming Care for Dual Eligibles initiative on June 17, 2009. This initiative, sponsored by the Center for Health Care Strategies, Inc. and funded by The Commonwealth Fund, will test innovative care models in eight states for people who are dually eligible for Medicare and Medicaid. In the session, entitled Medicare and Medicaid Data Analysis/Integration, Dr. Tucker focused on the integration and analysis of Medicare and Medicaid data; discussed his development and use of The Hilltop Crossover Framework-a new tool for the analysis of integrated care for dual eligibles; and discussed preliminary findings of his Robert Wood Johnson funded HCFO study of cross-payer effects for dual eligibles. To view the presentation, click here.
The Hilltop Institute is pleased to announce the addition of Cynthia Boddie-Willis, MD, MPH, as director of the newly reorganized Acute Care Policy and Research Unit. In this position, she will manage Hilltop’s initiatives in acute care policy, clinical and quality management, and research. Under her direction, Hilltop will continue to provide assistance to MCOs, state health agencies, local health departments, and other health care organizations in implementing Medicaid managed care programs; monitoring MCO performance; analyzing service utilization; identifying access barriers; evaluating the quality, affordability, and sustainability of publicly funded healthcare services; analyzing the administrative efficiency for health programs and systems; and informing health policy development. Her main research interest is in health disparities, a prominent theme of Hilltop’s work. Dr. Boddie-Willis was formerly Director of the Division of Health Promotion and Disease Prevention at the Massachusetts Department of Public Health, where she had oversight of the program development, implementation, and evaluation of health communications, health and the built environment, nutrition, physical activity, chronic disease prevention and management, healthy aging, health and disability, women’s health, and men’s health. In addition, she was a practicing physician at a federally qualified community health center, and hopes to continue to practice in Maryland. She comes to Hilltop with over 30 years of experience addressing the health care needs of vulnerable populations.
The Hilltop Institute and its subcontractor, Verité Healthcare Consulting, LLC, synthesized and analyzed the financial assistance and credit and collection policies of all 47 of Maryland’s hospitals to assist the Maryland Health Services Cost Review Commission (HSCRC) in their response to Governor O’Malley’s request that the HSCRC perform a thorough review of hospital debt collection practices. The purpose of the analysis was to determine: if a general consensus exists among Maryland’s hospitals on various key aspects of the policies; if the financial assistance policies comply with the voluntary guidelines established by the Maryland Hospital Association (MHA) as a minimum expectation for hospitals; and if such policies in Maryland are in accord with national trends and perspectives. Hilltop’s findings were incorporated in the HSCRC report, which was released on February 13, 2009.
The Hilltop Institute’s executive director, Charles Milligan, made a presentation at the 2nd Annual Medicaid Managed Care Summit on February 25, 2009. The presentation, entitled New Mexico’s Coordinated Long-Term Services (CoLTS) Program, was part of a track concerning SNPs (Special Needs Plans) and Integrating Medicaid and Medicare. Milligan painted a portrait of dual eligibles (persons dually eligible for Medicare and Medicaid), painted a portrait of long-term care, and discussed New Mexico’s approach to coordinate services for this population, their CoLTS program. This program, which Hilltop helped New Mexico develop, seeks to: promote community-based services (CBS) by diverting or shortening nursing home stays; promote flexible benefit design to achieve new CBS models; improve quality through coordination of Medicare and Medicaid; and achieve financial savings by aligning Medicare and Medicaid incentives. To view the presentation, click here.
The Hilltop Institute and the Maryland Department of Health and Mental Hygiene (DHMH) have been commissioned by the Robert Wood Johnson Foundation State Health Access Reform Evaluation (SHARE) Initiative to perform an evaluation of the Kids First Act. The Kids First Act is the first law in any state to utilize the income and household information reported on state income tax returns to target outreach efforts to children who may be eligible for Medicaid or SCHIP. This is SHARE’s first commission. Hilltop will perform the study, which will evaluate the success of the act’s outreach efforts. Study results should not only help Maryland reduce the number of uninsured children in the state, but also help inform policymakers in other states. Senior Research Analyst Cheryl Powell, MPP, at The Hilltop Institute, is the principal investigator for the project. She will lead Hilltop’s project team, which includes Senior Research Analyst Anna Sommers, PhD, and Urban Institute Consultant Stan Dorn, JD. DHMH Office of Eligibility Services Director Cheryl Camillo, MPA, is co-principal investigator.
The Hilltop Institute’s executive director, Charles Milligan, made a presentation to Michigan policymakers at an informational forum on December 11, 2008. In the presentation, entitled Integrated Managed Long-Term Care, Milligan gave a description of dual eligibles (persons eligible to receive both Medicare and Medicaid) and of long-term care; discussed various approaches to managed long-term care; described New Mexico’s approach, including their Coordination of Long-Term Services (COLTS) program, which Hilltop helped develop; and discussed Michigan’s challenges and opportunities for developing integrated managed long-term care. To view the presentation, click here.
The Hilltop Institute has won a contract from the New England States Consortium Systems Organization for Real Choices Long-Term Care Resource Mapping in the state of Rhode Island. Hilltop’s work will inform the state’s policy making by providing comprehensive information on Rhode Island’s current and projected population requiring publicly-financed long-term supports and services, the state’s institutional capacity, and the availability of community supports and services across the state. The project will also produce a tool for modeling the effects of various options for rebalancing state spending between institutional and home- and community-based services.
Cheryl Powell, senior research analyst at The Hilltop Institute, gave a presentation for the Transportation Association of Maryland’s 20th Annual Fall Conference, Reaching, Teaching, and Serving…Our 20 Year Journey, on October 20 and 21. In the presentation, entitled Maryland Medicaid Non-Emergency Medical Transportation Study, Powell described the study—which evaluated the feasibility of creating a uniform statewide NEMT program in Maryland; any potential cost savings or potential for quality improvement; and the potential impact of the creation of such a program on local health departments—and discussed its findings. Hilltop conducted the study, which was mandated by House Bill 235, on behalf of the Maryland Department of Health and Mental Hygiene. To view the presentation, click here.
The Hilltop Institute’s Director of Long-Term Supports and Services, Cynthia H. Woodcock, and Manager of Health Services Research, Al Adamson, presented a workshop on September 29, 2008, in Boston, at The Spirit of Independence: 24th National Home and Community Based Services Conference, convened by the National Association of State Units on Aging. In the workshop, entitled A Methodology for Projecting a State’s Long-Term Care Costs, they discussed the methodology that Hilltop developed to project long-term care costs in Maryland for 2010, 2020, and 2030; discussed how other states could use that methodology to project future spending; and offered guidelines on how states could facilitate change in their long-term care systems. To view the presentation, click here. To view the full report, click here.
The Hilltop Institute’s executive director, Charles Milligan, was an expert witness in an invitational forum hosted by The Heritage Foundation, on September 24, 2008, that explored innovative models for states’ reform of Medicaid programs and other vehicles for long-term care, paying particular attention to the concerns of the elderly and disabled. Entitled Workable Solutions for Long-Term Care, the forum simulated a Congressional hearing, in which health policy experts presented testimony and then fielded questions from a panel of distinguished members. Milligan presented in the session entitled Private Sector Models in the Context of Medicaid Reform, and focused on emerging opportunities to align Medicare and Medicaid payments and incentives. The goal of this alignment would be to reform Medicaid (and Medicare) to facilitate: the improvement of hospital discharge planning in a way that might avoid or reduce Medicaid-paid nursing facility stays; the improvement of the quality of long-term care services in a way that might avoid unnecessary Medicare-paid hospital admissions and emergency room use; and the promotion of greater flexibility in benefit delivery. To view Milligan’s testimony, click here.
The Hilltop Institute collaborated with the New Mexico Human Services Department in the development of a new coordinated long-term services program that has just received federal approval. The program will serve an estimated 38,000 Medicaid beneficiaries statewide, the vast majority of whom are enrolled in both Medicare and Medicaid (“dual eligibles”). The enrollees who are not dual eligibles will meet a nursing facility level of care even though many are already served in the community. Known as the Coordination of Long-Term Services (COLTS) Program, New Mexico’s model will operate under a Section 1915(b)(c) waiver from the Centers for Medicare and Medicaid Services (CMS), and the state will contract with two managed care organizations (MCOs) that are also Medicare Advantage Special Needs Plans. The state has two major goals in COLTS: to coordinate Medicare and Medicaid services by contracting with MCOs that may serve the beneficiaries in both programs, and to coordinate the full array of Medicaid services in order to promote community-based services where appropriate for the given beneficiary. The program will be implemented on a statewide basis over the next 11 months. Hilltop has been working with New Mexico over the past three years to design the program, develop the waivers, and advise the state on the capitated rate structure.
The Hilltop Institute has just released A Framework for State-Level Analysis of Duals: Interleaving Medicare and Medicaid Data as a resource guide for analysts who plan to integrate data on Medicare and Medicaid service use and costs. The Hilltop Crossover Framework is introduced in the guide as an orienting reference device for linked Medicare and Medicaid claims, and is based on a two-by-two format whereby data are arrayed by category of service-with specific reference to Medicaid crossover claims-in order to highlight the relationships between government programs and service use. The term “crossover” refers to Medicaid claims that reflect Medicare patient liability costs that state Medicaid programs cover on behalf of persons eligible under both programs-“dual eligibles” or “duals,” for short. The guide is also intended as a general introduction to Medicare and Medicaid benefits and attendant relationships for analysts who may be less familiar with one or both programs. To view the bulletin, click here.
The Hilltop Institute’s executive director, Chuck Milligan, gave a presentation on benefit design on August 4, 2008, before the Colorado Centennial Care Choices Program Panel, a governor-appointed expert panel charged with gathering information on the design, benefits, and costs of a Value Benefit Plan for the people of Colorado. Milligan discussed the concept of minimum benefits (a state’s determination of what constitutes “being insured”) and policy implications, such as the balance between a given state’s determination of where to strike a balance between its role to protect its citizens, and its role to respect individual liberty/autonomy to purchase services in the market; the balance between coverage by private insurance and government programs that wrap around those benefits; and the balance between covering more people with leaner benefits, or fewer people with more comprehensive benefits. Milligan then presented alternatives utilized by different states to provide benefits to their uninsured citizens.
The Center for Health Program Development and Management, located on Hilltop Circle at the University of Maryland, Baltimore County (UMBC), was established in 1994 in partnership with the Maryland Medicaid program. The name we chose for ourselves in 1994 reflected the activities that we performed for the Maryland Medicaid agency at that time: developing and managing selected health programs on their behalf. Our work for Maryland Medicaid continues to be fruitful, productive, and mutually beneficial. Over time, our work evolved. We now perform a much wider variety of health services research activities for Maryland Medicaid, as well as for a broad national collection of governmental and non-profit clients. The organizing mission of our work is to utilize analysis to advance the health of vulnerable populations. To view the bulletin, click here.