News & Bulletins Archive

The Hilltop Institute carried out a resource mapping project for the state of Rhode Island as part of the state’s efforts to create a more accessible system of long-term services and supports under their federal Real Choice Systems Transformation grant. Hilltop interviewed state agency staff on their perceptions of service gaps and barriers to accessing the system of long-term services and supports; conducted a survey of providers of long-term services and supports in the state about current and future capacity to serve Rhode Islanders; and constructed a rebalancing model for projecting utilization and expenditures for Medicaid long-term services and supports through 2030.

Click here to view Hilltop’s final report. Click here to view Hilltop’s presentation on the final report. Click here to view Hilltop’s presentation on the rebalancing model.

Hilltop Executive Director Chuck Milligan presented his paper, entitled Reshaping Medicaid, at the National Governors Association (NGA) State Summit on Health Reform on March 15, 2010, in Washington, DC. This invitational summit brought together four key stakeholders from each state—the Governor’s health policy advisor, the state’s Medicaid Director, the state’s Insurance Superintendant, and another individual selected at the state’s discretion—to explore and discuss health reform from the state perspective. The session, entitled Modernizing and Expanding Medicaid, focused on emerging opportunities and challenges in Medicaid, related to and independent of federal health reform. Following presentation of his paper, Milligan moderated a panel discussion that included Cindy Mann, Director of the Center for Medicaid and State Operations, Centers for Medicare and Medicaid Services; Carol Steckel, Commissioner of the Alabama Medicaid Agency; and Jason Helgerson, Medicaid Director, Wisconsin Department of Health Services. To view the conference proceedings, click here.

Hilltop Executive Director Charles J. Milligan, Jr., participated on a panel at the 3rd Annual Medicaid Managed Care Summit in Washington, DC on February 25, 2010. The summit examined policy changes, Health Care Reform, and funding opportunities, as well as explored strategic answers to the core challenges in managed care. The panel, entitled Establishing Coordinated LTSS [long-term supports and services] Programs: Solutions for Medicaid, States, and Consumers that Promote Improved Quality and Flexibility, brought together Milligan and other experts in long-term care who presented challenges and solutions for the largely unmanaged portions of state Medicaid budgets dealing with long-term care services from a fiscal, medical, and operations perspective with an emphasis on the perspective of seniors and people with disabilities. The discussion included: identifying the personal care needs of seniors and people with disabilities; public policy considerations for personal care that preserve independence and freedom; examples of successful State LTSS programs, including the New Mexico Coordination of Long-Term Services (CoLTS) Program, which Hilltop helped develop; and demonstrating how managed care can transform to coordinated LTSS. To view the panel slides, click here.  

Hilltop Medicaid Policy Studies Director David Idala, MA, discussed Maryland’s strategy for targeting public program enrollment efforts at a webinar hosted by the State Health Access Reform Evaluation (SHARE) on February 24, 2010, entitled Using Income Tax Information to Target Medicaid and CHIP Outreach. Idala’s presentation, entitled Maryland’s Kids First Act: Using Tax Forms to Identify Medicaid/CHIP-Eligible Children, discussed the findings of Hilltop’s evaluation and reviewed data collection, outreach strategies, impact on enrollment, and lessons learned. The evaluation was funded by SHARE, a national program of the Robert Wood Johnson Foundation®, with direction by the State Health Access Data Assistance Center at the University of Minnesota School of Public Health. To view the presentation, click here. To access the SHARE Issue Brief on the evaluation’s results, click here. To listen to the webinar, click here.

The Hilltop Institute has released a new report entitled, Examining the Medicare Resource Use of Dually Eligible Medicaid Recipients. The report, authored by Anthony M. Tucker, PhD, Karen E. Johnson, MS, Yi Huang, PhD, and Tonya Brewer, MPH, is the third in a series that explores the cross-payer effects of providing Medicaid long-term supports and services (LTSS) on Medicare acute care resource use. The report reflects an exploratory analysis of the relationships between Medicare and Medicaid resource use to address the question: Does providing Medicaid LTSS influence dually eligible Medicaid recipients’ use of Medicare resources and, if so, how and to what extent? Report results suggest two general aspects of these effects: (1) Medicaid LTSS provided in the community are associated with an increase in the number of Medicare services used with no, or limited, additional Medicare costs overall, and (2) Medicaid institutional supports offset Medicare resource use overall. The report also highlights analytic methods used, including propensity score matching techniques. The view the report, click here. To view the bulletin, click here.

Hilltop Executive Director Charles Milligan testified before the Maryland State Senate Finance Committee on February 2, 2010, regarding proposed legislation to require chronic care hospitals to develop a financial assistance policy for providing free and reduced–cost care, as well as to establish debt collection policies and procedures. This legislation was developed as a result of recommendations made by a work group convened by the Health Services Cost Review Commission (HSCRC) to review hospital financial assistance and debt collection policies and practices. Hilltop provided in-depth analyses of these policies and practices to inform the group’s work. Milligan testified on a panel with Robert Murray, executive director, and Steve Ports, principal deputy director, of HSCRC.

To disseminate the findings of the first formal evaluation of New Mexico’s State Coverage Insurance (SCI) program, The Hilltop Institute at UMBC has just released a new issue brief entitled Small Business Participation in the New Mexico State Coverage Insurance Program: Evaluation Results. The purpose of the study was to identify factors that have influenced employer participation in SCI. The evaluation was partially funded by the Robert Wood Johnson Foundation’s State Health Access Reform Evaluation (SHARE) program through a partnership between the New Mexico Human Services Department (HSD) and The Hilltop Institute. Hilltop Senior Research Analyst Anna S. Sommers, PhD, was principal investigator for the project. To view the issue brief, click here. To view the bulletin, click here.

The Hilltop Institute has just released a new series of chart books, entitled Medicaid Long-Term Supports and Services in Maryland, that summarizes demographic, service utilization, and expenditure data for state fiscal years 2001 through 2008 on three Maryland Medicaid waiver programs—the Older Adults Waiver, the Living at Home Waiver, and the Autism Waiver—and on nursing facility utilization among Maryland Medicaid recipients. These chart books, prepared for the Maryland Department of Health and Mental Hygiene and now made available to the public online, are intended to monitor trends in these programs. Hilltop plans to update the chart books annually. To view the bulletin, click here.

The Hilltop Institute assisted the New Mexico Human Services Department with preparing the application to the Centers for Medicare and Medicaid Services (CMS) for a Section 1115 Medicaid Demonstration project entitled the New Mexico State Coverage Insurance (SCI) Demonstration. This demonstration will  permit the state to continue coverage for non-pregnant childless adults aged 19 through 64, with incomes up to and including 200 percent of the federal poverty level (FPL). The program is designed to provide health care coverage to uninsured individuals who are unemployed, self-employed, or employed by a participating small business employer. The program was previously funded through a Section 1115 waiver under the Children’s Health Insurance Program (CHIP). When the program was reauthorized in 2009, a new waiver was necessary. Hilltop worked with New Mexico on the development of the waiver application, including performing the analysis to determine and establish budget neutrality.

Hilltop Executive Director Charles Milligan gave a webinar for state officials on January 15, 2010. In this webinar, sponsored by the Robert Wood Johnson Foundation State Coverage Initiatives (SCI) program administered by AcademyHealth, Milligan discussed the current status of national health reform and its potential impact on the states. Milligan provided participants with the most up-to-date information on where things stand in the process, including the major areas of House-Senate agreement, the minor and major areas of House-Senate disagreement, and key implications for states. To view the presentation, click here.

Hilltop Executive Director Charles Milligan participated on a panel that made a presentation before the Health and Government Operations Committee of the Maryland House of Delegates at a hearing on November 17, 2009, entitled Federal and State Trends in Hospital Oversight. The other presenters were Keith Hearle, President of Verité Healthcare Consulting, LLC, and Donna Folkemer, Group Director of the National Conference of State Legislatures. The presentation described national trends in tax-exempt hospital oversight; discussed state policy directions in financial protections for hospital customers; and presented two catalysts for state policymaking: insurance coverage rates and hospital behavior. Click here to view the presentation.

Hilltop Director of Long-Term Supports and Services Cynthia Woodcock presented findings from a Hilltop study directed by Senior Research Analyst Harriet Komisar, PhD, of community-based services in 11 states at the Maryland Department of Health and Mental Hygiene (DHMH) Long-Term Care Payment Advisory Committee (LTC PAC) meeting on November 12, 2009. Entitled Medicaid Rate-Setting Methods for Community Services in Selected States, the presentation described the community service system in Maryland, discussed the study, and presented the findings. The study focused on rate-setting methods for personal care, adult day care, and assisted living. Click here to see Hilltop’s presentation.

Hilltop Research Analyst Laura Spicer presented the findings of Hilltop’s evaluation of the New Mexico State Coverage Insurance (SCI) program at the Association for Public Policy Analysis and Management (APPAM) 31st annual research conference, Evidence-Based Policy Making in the Post-Bush/Clinton Era, on November 7, 2009, in Washington, D.C. Entitled Evaluation of Small Group Employer Participation in New Mexico’s State Coverage Insurance (SCI) Program, the presentation was part of a panel on state health policy. In the presentation, Spicer gave an overview of the SCI program; presented results of the Hilltop surveys of employers who participated as well as those who inquired about but did not participate in the program; discussed implications for states that want to engage small businesses to participate in state coverage initiatives; and discussed implications for federal reform. To view the presentation, click here. In addition, on November 5, 2009, Hilltop Executive Director Charles Milligan was a discussant on a panel entitled Working with States to Develop Health Care Reform Initiatives: Research, Analysis, Politics, which addressed various aspects of health care reform at the state level.

This October, Hilltop Executive Director Charles Milligan has been making presentations to groups around the country on health care reform. On October 13, 2009, Milligan presented at an AcademyHealth-sponsored national teleconference. Over 100 lines called in, from Governor’s offices, insurance departments, Medicaid and SCHIP agencies, and so on, representing over 40 states. On October 23, 2009, Milligan gave a presentation to the Louisiana Health Care Commission; on October 24, 2009, he gave a presentation to the National Association of Latino Elected and Appointed Officials (NALEO) Latino Legislative Summit on Health Disparities. In each presentation, Milligan described the health care reform process currently occurring in Congress, gave an update on the status of the Senate and House bills, and discussed two scenarios for how the process could conclude. For the Latino Legislative Summit, Milligan also discussed implications for states based on each scenario. To view the Summit presentation, which includes the implications for states, click here.

Hilltop Senior Research Analyst Harriet L. Komisar, Ph.D., gave a presentation at the New York Institute of Technology (NYIT) Center for Gerontology and Geriatrics Second Annual Conference on Aging and Society: “Reforming Long Term Care—Back to the Future” on October 7, 2009, in Westbury, New York. Komisar’s presentation, entitled You Can Run, But You Can’t Hide: Facing the Costs of Long-Term Care, provided an overview of long-term care (LTC), the population who utilizes it, and the common types of LTC assistance needed; discussed the costs of LTC from both an individual’s perspective and the national perspective; and made suggestions as to how the nation can prepare to meet the future needs of this increasing population. To view the presentation, click here.