News & Bulletins Archive
Hilltop’s Hospital Community Benefit Program has just released the ninth issue brief in its series, Hospital Community Benefits after the ACA. This brief, Addressing Social and Economic Factors that Shape Health, continues the program’s examination of state-level community benefit oversight by focusing on the ten states that require hospitals to develop implementation strategies.
Hilltop Senior Research Analyst Michael T. Abrams, MPH, co-authored two articles published in the April 2014 issue of Psychiatric Services. The articles are both based on a study of low-income young adults (aged 18-26) discharged from an inpatient psychiatric event, a marker for serious mental distress. Identifying Young Adults at Risk of Medicaid Enrollment Lapses after Inpatient Mental Health Treatment discusses a study that identified antecedents to Medicaid enrollment lapses in the year following discharge. Such lapses are undesirable because they suggest absence of medical attention that is especially indicated in the wake of an inpatient psychiatric stay. Medicaid Lapses and Low-Income Young Adults’ Receipt of Outpatient Mental Health Care after an Inpatient Staydiscusses a second study that estimated the impacts of Medicaid enrollment disruptions on access to mental health services in the same year following inpatient discharge. That study found that Medicaid disruptions correlated with reduced outpatient mental health service utilization and lower medication possession ratios. Jointly, these articles offer information to policymakers and others regarding the reasons and the potentially negative health care consequences of insurance discontinuities for young adults with substantial (albeit emerging) mental health needs. Such young adults represent an important subset of persons who should gain broader access to medical care coverage via the Affordable Care Act.
In collaboration with a team that includes researchers at Johns Hopkins and UMBC’s Department of Public Policy, researchers at The Hilltop Institute have published a new peer-reviewed article in the AcademyHealth journal eGEMstitled Estimating Causal Effects in Observational Studies Using Electronic Health Data: Challenges and (some) Solutions. Researchers used Medicaid and Medicare administrative data to study the impact of the Medicare prescription drug program, Part D (first implemented in 2006), on persons with serious mental illness (SMI). Such a study is important because persons with SMI are medically vulnerable and because a large proportion of their prescription drug health care coverage shifted from state to federal responsibility as a result of the Part D program. The published study describes propensity score methods to “match” persons with Medicare and Medicaid coverage (dual eligibles) to persons with similar demographic and health profiles who are only engaged in Medicaid. Such matching is necessary to balance the selected samples so that they are comparable for inference testing. The suggested citation for this work appears below, and the full article can be viewed here: http://repository.academyhealth.org/egems/vol1/iss3/4. For more information about this work, please contact Hilltop Senior Policy Analyst, Michael Abrams at mabrams@hilltop.umbc.edu.
Stuart, E. A., DuGoff, E., Abrams, M., Salkever, D., & Steinwachs, D. (2013). Estimating causal effects in observational studies using electronic health data: Challenges and (some) solutions. eGEMs (Generating Evidence & Methods to improve patient outcomes), Vol. 1, Iss. 3, Article 4. DOI: 10.13063/2327-9214.1038
The Hilltop Institute’s Hospital Community Benefit Program has received a grant from the Robert Wood Johnson Foundation® to continue to provide timely information on emerging trends and important issues related to community benefit. The program will produce three issue briefs as part of its Hospital Community Benefits after the ACA series over an eighteen-month period, the first of which will be published in the spring of 2014.
Hilltop Director of Medicaid Policy Studies David A. Idala, MA, presented a poster at the American Public Health Association 141st Annual Meeting and Exposition held November 2-6, 2013, in Boston, MA. The poster, titled The Use of Emergency Department Services for Non-Emergent Conditions among Adults with Disabilities, displayed the methods and findings of a study of the relationship between emergency department use and disability in adults. View the poster.
Hilltop staff made two panel presentations and a poster presentation at Evaluation 2013: The State of Evaluation Practice in the Early 21st Century, the27th Annual Conference of the American Evaluation Association held from October 16-19, 2013, in Washington, DC. Hilltop Senior Policy Analyst Charles Betley, MA, presented a poster titled The Use of Emergency Department Services for Non-Emergent Conditions among Adults with Disabilities, which displayed the methods and findings of an study of the relationship between emergency department use and disability in adults. View the poster. Hilltop Policy Analyst Jessica Skopac, JD, PhD, MA, gave a presentation titled Utilizing “The Guide” to Strengthen Partnerships and to Inform Evaluation Planning for the Maryland Asthma Control Program, in which she discussed the methods and findings of Hilltop’s evaluation of the MACP and how to engage partners more effectively. View the presentation.
The Hilltop Institute’s Hospital Community Benefit Program has just released the eighth issue brief in its series, Hospital Community Benefits after the ACA. This brief, Present Posture, Future Challenges, focuses on updating significant points concerning community health needs assessment (CHNA) and other aspects of community benefit discussed in earlier briefs in the series, as well as on identifying and exploring more recent developments and emerging issues.
On October 8, 2013, Hilltop Executive Director Cynthia H. Woodcock, MBA, gave a presentation at the National Conference of State Legislatures (NCSL) Fiscal Analysts Seminar. The seminar, held in Annapolis October 6 through October 9, was attended by fiscal staff from across the country. In her presentation titled Integrating and Coordinating Care for Dually Eligible Individuals, Woodcock discussed the characteristics of Medicare-Medicaid enrollees (dual eligibles); pathways to dual eligibility; opportunities for and challenges of integrating care for this population; approaches to integrating care; and what questions to ask about program design, financing, managed care organizations, data and IT, quality monitoring, stakeholders, program roll-out, and resources.
The Hilltop Institute is pleased to announce that Gayle D. Nelson, JD, MPH, is the new director of its Hospital Community Benefit Program. Nelson is a senior policy analyst at The Hilltop Institute and has been with the program since she joined Hilltop in 2012. She is co-author of the program’s issue briefs and led the development and implementation of Hilltop’s online resource, the Community Benefit State Law Profiles, a compilation of each state’s community benefit laws and regulations, analyzed in the context of the Affordable Care Act’s (ACA’s) community benefit framework.
The Hilltop Institute’s Hospital Community Benefit Program has just released a second issue brief related to its online resource, the Community Benefit State Law Profiles. This brief, Hospital Community Benefits after the ACA: Policy Implications of the State Law Landscape, describes state community benefit requirements organized into eight categories that largely reflect either pre-existing federal community benefit standards or additional requirements set forth in §9007 of the Affordable Care Act (ACA). It also compares and contrasts various states and discusses the policy implications of the findings.
The U.S. Department of Housing and Urban Development has awarded a three-year, $750,000 grant to UMBC’s Hilltop Institute and Maryland Institute for Policy Analysis and Research (MIPAR), as well as the Green and Healthy Homes Initiative™(GHHI), to conduct a cost benefit analysis of the reduction in asthma and associated Medicaid expenditures resulting from the implementation of GHHI’s interventions. GHHI is a national program spearheaded by the Coalition to End Childhood Lead Poisoning with the aim of integrating health-based housing interventions with weatherization to create access to healthy homes for children in low-income neighborhoods. The UMBC study will focus on GHHI interventions in the homes of low-income families with asthma-diagnosed children in Baltimore City. The project will evaluate the extent to which GHHI interventions affect asthma morbidity and health care utilization costs, school absences, utility costs, and work-loss days for parents or caregivers of children with asthma. The study will also examine how different levels of GHHI interventions affect post-intervention resident health and overall non-medical and energy cost savings. The interdisciplinary research team includes Principal Investigator David Salkever of the UMBC Department of Public Policy/MIPAR, Co-Investigator Michael Abrams of The Hilltop Institute, researchers from the Johns Hopkins School of Medicine and the Johns Hopkins Bloomberg School of Public Health, and Co-Principal Investigator Ruth Ann Norton, Executive Director of the Coalition to End Childhood Lead Poisoning/GHHI.
The Hilltop Institute has just released the latest in a series of summaries of federal guidance issued pursuant to the Affordable Care Act (ACA). Overview of the Final Rule on Medicaid, CHIP, and Exchanges provides a detailed yet concise summary of the rule issued by the U.S. Department of Health and Human Services on July 5, 2013, and highlights key changes to the regulation since the issuance of the proposed rule in January 2013.
Community Benefit State Law Profiles, the interactive online tool developed by Hilltop’s Hospital Community Benefit Program, are featured in the Centers for Disease Control and Prevention’s (CDC’s) July 2013 edition of Public Health Law News. In this article, the CDC links to the Profiles, which “present a comprehensive analysis of each state’s community benefit landscape as defined by its laws, regulations, tax exemptions, and, in some cases, policies and activities of state executive agencies.”
Hilltop Hospital Community Benefit Program Director Martha Somerville, JD, MPH, and Policy Analyst Gayle Nelson, JD, MPH, presented a poster at the National Association of County and City Health Officials (NACCHO) annual conference held July 10-12, 2013, in Dallas, Texas. The poster, Community Benefit State Law Profiles, highlights the variation in community benefit laws across states in comparison with the federal community benefit standard and showcases the program’s online tool, where users can compare these requirements across states. View the poster.
Hilltop’s economic analysis using the Hilltop Health Care Reform Simulation Model was cited by several news sources today. It was cited on Baltimore’s radio station WYPR’s Maryland Morning. The show, How the Health Care Law is Affecting Maryland’s Small(ish) Businesses, explored how the ACA will affect small businesses and their employees and what the recent delay in the ACA’s implementation will mean for them. Hilltop’s most recent simulation for the Maryland Health Benefit Exchange estimated that approximately 10,000 people will be affected by the law’s mandate that individual workers have health coverage, with 5,000 anticipated to find insurance from the Maryland Health Connection and 5,000 to remain uninsured. The Baltimore Sun’s report, Businesses welcome reprieve from offering insurance, by Andrea Walker on the same subject, cites this analysis, and a report on WebMD Health News titled Maryland Delays Small-Business Enrollment, by Bara Vaida, also cites this analysis. Another piece that mentions Hilltop, Maryland Health Connection to assist families, small businesses in comparing health insurance options, was published in the Herald-Mail.