Since the enactment of the Affordable Care Act (ACA) in 2010, there has been consistent federal guidance employing and clarifying its provisions. Hilltop develops regulation summaries to assist state and local policymakers in their implementation of health reform. On January 14, 2013, the U.S. Department of Health and Human Services (HHS) issued a Notice of Proposed Rulemaking (NPRM) on various eligibility and administrative provisions for insurance affordability programs under the ACA. This document provides a high-level summary of this rule and highlights the items for comment.
The Medicaid Long-Term Services and Supports in Maryland Chart Book, Volume 2, The Autism Waiver is the second chart book in a series of two that explores service utilization and expenditures for Medicaid-funded long-term services and supports in Maryland. The first chart book in the series explores service utilization and expenditures for Maryland Medicaid’s Living at Home Waiver, Older Adults Waiver, and Medical Day Care Waiver, as well as Maryland State Plan personal care services and Medicaid nursing facility utilization and expenditures.
This chart book provides information about Maryland Medicaid participants who received services through the Autism Waiver in fiscal year (FY) 2008 through FY 2011.
This document provides additional analysis requested by the Continuity of Care Advisory Committee and public stakeholders and serves as an addendum to the Committee’s report, Analysis of Options to Ensure Continuity of Care.
The Maryland Health Benefit Exchange Act of 2012 requires the Maryland Health Benefit Exchange (MHBE) to conduct a study and report findings and recommendations to the Governor and General Assembly on “the establishment of requirements for continuity of care in the State’s health insurance markets (2012, Md. Laws, Ch. 152).” To meet this legislative charge, the MHBE established the Continuity of Care Advisory Committee in the fall of 2012 and issued a request for proposal (RFP). The RFP sought a consultant to conduct a study evaluating options for continuity of care provisions to assist beneficiaries who may transition between coverage under Medicaid/the Maryland Children’s Health Program (MCHP) and qualified health plans (QHPs) offered through the MHBE. The MHBE contracted with Hilltop to conduct this study and provide staff support to the Continuity of Care Advisory Committee. The Committee, consultant, and the public worked collaboratively to develop a set of options and considerations for the MHBE Board of Trustees.
The purpose of this report is to present the results of the study and summarize the Committee’s discussions and written comments to help guide the MHBE Board as it makes recommendations to the Governor and General Assembly.
Hilltop Long-Term Services and Supports Policy and Research Director Donna C. Folkemer, MA, gave this presentation at the National Conference of State Legislatures (NCSL) Fall Forum Pre-Conference Meeting on December 5, 2012, in Washington, DC. Folkemer discussed eight things legislators should know about quality. The pre-conference meeting was attended by legislators and legislative staff from across the country.
Senior Policy Analysts Laura A. Spicer, MA, and Charles Betley, MA, gave this presentation at a Continuity of Care Advisory Committee Meeting. The Committee was appointed by the Board of Trustees in June of 2012 to begin addressing the transition between Medicaid, the state-based exchange and the commercial market.
Hilltop made several presentations at the 65th Annual Scientific Meeting of the Gerontological Society of America that took place November 14-18, 2012, in San Diego. On November 14, Hilltop presented a symposium session titled Medicare-Medicaid Enrollees: An Examination of New Maryland Enrollees and Pathways to Coverage. The purpose of the session was to discuss the findings of the research Hilltop conducted to examine the experience of Maryland Medicare-Medicaid enrollees before their eligibility for both programs. The research identified and cataloged significant differences between persons who first enroll in Medicaid and then in Medicare and those who first enroll in Medicare and then in Medicaid. In the session, Hilltop researchers shared the results of their analyses and findings from a background paper about pathways to eligibility for both programs. Hilltop Director of Long-Term Services and Supports Policy and Research Donna Folkemer, MA, moderated the session. Cynthia Woodcock, MBA, formerly of Hilltop and now Practice Area Lead, Long-Term Care, Aging, and Disability at IMPAQ International, discussed the literature review that described the various pathways to eligibility, presented examples of programs aimed at delaying functional decline and/or poverty, and reviewed enrollment barriers faced by individuals who need both Medicare and Medicaid coverage. Hilltop Policy Analyst Aaron Tripp, MSW, discussed the study on demographic and programmatic characteristics, which compared and contrasted enrollees in both programs with particular attention to identifying differences among various groups. Hilltop Director of Special Studies Ian Stockwell, MA, discussed the study on prior Medicare and Medicaid resource use, which examined chronic disease patterns and prior health care expenditures of persons who began to receive coverage in 2008 from both Medicare and Medicaid. Chuck Milligan, JD, MPH, Maryland Department of Health and Mental Hygiene Deputy Secretary of Health Care Financing, was the discussant for the session.
This issue brief highlights key findings from Hilltop’s study that evaluated the Kids First outreach initiative. The overarching goal of the study was to evaluate the implementation of Kids First and how well the state achieved its goal of identifying and enrolling uninsured children who are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) in order to glean lessons for not only Maryland, but also other states. This brief describes the factors that facilitated Kids First, as well as the key challenges that Maryland faced as it implemented the initiative.
HealthChoice, Maryland’s statewide mandatory Medicaid managed care program, was implemented in 1997 under authority of Section 1115 of the Social Security Act. The HealthChoice managed care program currently enrolls over 80 percent of the state’s Medicaid population. The program also enrolls children in the Maryland Children’s Health Program (MCHP), Maryland’s Children’s Health Insurance Program (CHIP). Since the program’s inception, the Maryland Department of Health has conducted four comprehensive evaluations as part of the 1115 waiver renewals. Between waiver renewals, the Department continually monitors HealthChoice performance on a variety of measures and completes an annual evaluation for HealthChoice stakeholders. This report is the 2011 annual evaluation of the HealthChoice program.
The Hilltop Institute developed a Health Care Reform Simulation Model, a financial modeling tool that projects the costs and savings of implementing the provisions of the Affordable Care Act (ACA), for the state of New Mexico. The basic approach of the simulation model developed for New Mexico was to compare the new costs and savings associated with health care reform with a baseline assumption of what those costs and savings would have been in the absence of reform.
This is a user’s guide for the fiscal model.
For this guide, we have assumed that model users have read the document, New Mexico Health Care Reform Fiscal Model: Detailed Analysis and Methodology, and are familiar with the methods of analysis that were used to develop the fiscal model.