This is the eleventh issue brief in a series published by the Hospital Community Benefit Program. This brief discusses the fact that payment reform focusing on value and quality is driving change that is redefining the hospital’s role in the continuum of care and the health of the broader population. This brief also identifies opportunities for state policymakers to encourage the evolution of hospital community benefit policy in ways that complement and support the realignment of the hospital business model, proactively address the social determinants of health, and ultimately improve the health of the entire community.
This is the tenth issue brief in a series published by the Hospital Community Benefit Program. This brief examines state-level community benefit oversight by studying specific changes to community benefit statutes, regulations, and policies in 5 states selected from among the 40 states known to provide oversight of any type. These five states—Colorado, Illinois, Minnesota, New Hampshire, and New York—adopted changes during the period spanning four years before and after adoption of the Affordable Care Act.
Pursuant to SB 481 (Chapter 464 of the Acts of 2002), the Maryland Department of Health and Mental Hygiene (the Department) created an annual process to set the fee-for-service (FFS) reimbursement rates for Maryland Medicaid and the Maryland Children’s Health Program (MCHP) in a manner that ensures provider participation. The law directs the Department to submit an annual report to the Governor and various House and Senate committees addressing the progress of the rate-setting process; a comparison of Maryland Medicaid’s reimbursement rates with those of other states; the schedule for adjusting Maryland’s reimbursement rates; and the estimated costs of implementing the above schedule and proposed changes to the FFS reimbursement rates. This is the Department’s annual report dated January 2015.
This report describes the services The Hilltop Institute provided to the Maryland Department of Health and Mental Hygiene (DHMH) under the 2014 Memorandum of Understanding between Hilltop and DHMH. The report covers state fiscal year 2014 (July 1, 2013, through June 30, 2014). Hilltop’s interdisciplinary staff provided a wide range of services, including: Medicaid program development and policy analysis; HealthChoice program support, evaluation, and financial analysis; long-term services and supports program development, policy analysis, and financial analytics; and data management and web-accessible database development.
Health Homes are intended to improve health outcomes for individuals with chronic conditions by providing patients with an enhanced level of care management and care coordination. The goal of this report is to provide a description of Medicaid enrollees’ participation in the Maryland Health Home program and their interactions with the health care system during the first year of program implementation.
Hilltop Senior Policy Analyst Stephanie Cannon-Jones, MPP, gave a presentation at the 25th Annual State of the States in Head Injury Conference on October 28, 2014 in Philadelphia, PA. Cannon-Jones described the key findings of a study that examined Medicaid expenditures and service utilization patterns of Maryland Medicaid-eligible beneficiaries with a brain injury diagnosis who resided in nursing facilities.
Hilltop Hospital Community Benefit Program Director Gayle Nelson gave this presentation at the National Academy for State Health Policy’s 27th Annual State Health Policy Conference on October 8, 2014, in Atlanta, Georgia. Nelson discussed hospital community benefits and various approaches states could use to leverage them to improve population health.
With the establishment of the Exchange in Maryland law in 2012, the memorandum of understanding (MOU) that supported Hilltop’s work on health care reform between the Maryland Department of Health and Mental Hygiene (DHMH) and Hilltop transitioned to one between the Maryland Health Benefit Exchange (MHBE) and Hilltop.
This report presents the activities and accomplishments of that MOU, covering February 1, 2013, through March 31, 2014.
Hilltop Director of Special Studies Ian Stockwell, PhD, gave this presentation at the National Association of States United for Aging and Disabilities’ National Home & Community Based Services Conference in Arlington, Virginia, on September 18, 2014. Stockwell discussed selection and use of assessment tools—which can have a broad effect across program and policy areas—and how this selection and use can help realize the potential to pull individual-level information together to form a complete picture of a program population.
During the 2013 Legislative Session, the Maryland General Assembly passed House Bill 228 (Chapter 159, Acts of 2013), entitled the Maryland Health Progress Act of 2013. Section 6 of Chapter 159 requires the Maryland Health Benefit Exchange (MHBE) and the Maryland Insurance Administration (MIA) to conduct a joint study of the impact of the Affordable Care Act’s allowance of a tobacco use rating of 1.5 to 1, including (1) its effect on insurance premiums generally; (2) its effect on the affordability and purchase of insurance, and access to health care, for tobacco users; and (3) any disparate impact on specific vulnerable populations. The study must further assess the options that may be available to the state to address any adverse consequences of tobacco use rating.
Hilltop worked with the MHBE and the MIA to conduct this legislatively mandated study. This report contains the findings of the study and concludes with options for further legislative action.