News & Bulletins Archive

Hilltop Executive Director Charles Milligan participated in a meeting for congressional and federal staff hosted by the National Health Policy Forum on October 29, 2010, in Washington, D.C. This meeting, the seventh of the Focus on Reform series providing an in-depth look at various components of the Affordable Care Act (ACA) and related implementation and operational issues, was entitled Medicaid Long-Term Services and Supports (LTSS) Provisions in PPACA. The session provided an overview of the Medicaid LTSS provisions enacted as part of the ACA, including the Community First Choice and Section 1915(i) state plan options; and the balancing incentive payments (BIP) and Money Follows the Person (MFP) programs, among others. Speakers described the provisions; strategies being employed by the Centers for Medicare & Medicaid Services (CMS) to assist states implement the various options, and opportunities and challenges facing states in implementation of the provisions. In his presentation, Milligan discussed the growth in Medicaid expenditures for LTSS; presented the results of a Hilltop study of Medicare/Medicaid cross-payer effects that found that Medicare and Medicaid financing do not align to promote home and community-based services (HCBS); described state and federal opportunities and barriers; and forecasted the take-up of LTSS options in the ACA. To view the presentation, click here.

The Hilltop Institute at UMBC is proud to announce the opening of its new Hospital Community Benefit Program. Made possible by the generous support of the Robert Wood Johnson Foundation and the Kresge Foundation, the program will be the first ever central resource created specifically for state and local policymakers to improve the reporting and evaluation of tax-exempt hospitals’ community benefit activities. The Hospital Community Benefit Program will be a resource to state and local health departments, hospital regulators, legislators, revenue collection and budgeting agencies, and hospitals, as each entity works to improve the transparency, comparability, fairness, and effectiveness of the community benefits delivered by tax-exempt hospitals. To view the bulletin, click here.

Hilltop Executive Director Charles Milligan was one of three experts who spoke at the UMBC Public Policy Forum entitled Health Care Reform: What Will It Mean to Maryland?, held October 22, 2010, in Baltimore, Maryland. In his presentation, entitled What Federal Health Care Reform Legislation Means to States, Milligan gave an overview of the new federal health reform legislation, the Affordable Care Act (ACA), and discussed its implications for states regarding Medicaid; exchanges; insurance-related issues; information technology; long-term services and supports; workforce issues; and preventive services and public health. Other speakers included Maryland Department of Health and Mental Hygiene Secretary John Colmers, who spoke about Maryland’s implementation plans and the Health Care Reform Coordinating Council, which he co-chairs; and Paul Fronstin, Senior Research Associate at the employee Benefit Research Institute, who spoke about the ACA’s implications for employers and employees. About 100 people from across Maryland were in attendance. Hilltop co-sponsored the forum with the UMBC Department of Public Policy, the Maryland Institute for Policy Analysis and Research, and the Annie E. Casey Foundation. To view Milligan’s presentation, click here. To view Colmers’ presentation, click here.

Hilltop Executive Director Charles Milligan gave a presentation at the closing general session of the American Health Insurance Plans (AHIP) Medicaid Conference on September 16, 2010, in Washington, DC. The session, entitled Opportunities for Medicare/Medicaid Integration: Serving Dual-Eligible Beneficiaries, addressed issues surrounding coordination of coverage and seamless integration of benefits for dually eligible individuals. Milligan’s presentation painted a portrait of dual eligibles, using Maryland as an example; gave an overview of cross-payer effects for dual eligibles and of Hilltop’s research on cross-payer effects for dual eligibles in Maryland; and discussed the study’s findings and policy implications. To view the presentation, click here.

This public policy forum will describe how Maryland plans to implement health care reform, with a focus on the impact of expanded coverage for working families. Speakers include Charles Milligan, Executive Director of The Hilltop Institute; John Colmers, Secretary of the Maryland Department of Health and Mental Hygiene; and Paul Fronstin, Senior Research Associate for the Employee Benefit Research Institute. Public Policy Professor Nancy Miller will moderate. To view the bulletin, click here.

The Maryland Health Care Reform Coordinating Council (HCRCC) released its Interim Report at a press conference in Baltimore on July 26, 2010. The report is the result of the HCRCC’s efforts since March 2010, when it was appointed by Maryland Governor Martin O’Malley to make recommendations regarding Maryland’s implementation of the recently enacted federal health reform legislation, the Patient Protection and Affordable Care Act (PPACA). The report includes: an overview of the federal law and its general implications for reform in Maryland; the role and mission of the HCRCC; the opportunities and challenges presented by reform implementation and the principles by which it must be guided; the state’s unique health care landscape and regulatory environment against which implementation decisions must be made; the projected fiscal impact of reform over the next decade; the workgroup process through which the HCRCC will formulate its recommendations on the decisions most critical to Maryland’s success; and a timeline for planning and key activities. The HCRCC is co-chaired by the Honorable Anthony G. Brown, Lieutenant Governor of Maryland, and John M. Colmers, Secretary of the Maryland Department of Health and Mental Hygiene. The HCRCC is staffed by Charles J. Milligan, The Hilltop Institute’s executive director, and Alice Burton, principal at Riverside Consulting, LLC. To support the HCRCC’s work, Hilltop researchers conducted an in-depth analysis of the provisions of PPACA and developed a financial model to project Maryland’s costs and savings associated with implementing health care reform. The model, based on current assumptions, predicts that health care reform could save Maryland an estimated $829 million in health care costs in the next decade. To learn more about the HCRCC and view the report, visit www.healthreform.maryland.gov/interimreport.html.

Hilltop Executive Director Charles Milligan presented the luncheon keynote address at the second State Health Access Program (SHAP) All Grantee meeting on July 26, 2010, in Arlington, VA. Milligan’s keynote, entitled Implementation of the Affordable Care Act, focused on state opportunities and major decisions related to federal health reform and offered suggestions for the role that SHAP grantees could play in their respective states. To view the presentation, click here.

Hilltop Executive Director Charles Milligan presented the luncheon keynote address at the second State Health Access Program (SHAP) All Grantee meeting on July 26, 2010, in Arlington, VA. Milligan’s keynote, entitled Implementation of the Affordable Care Act, focused on state opportunities and major decisions related to federal health reform and offered suggestions for the role that SHAP grantees could play in their respective states. To view the presentation, click here.

Hilltop Executive Director Charles Milligan participated in a roundtable at the 2010 AcademyHealth Annual Research Meeting on June 28, 2010, in Boston, Massachusetts. The session, Balancing LTC: Can More Home and Community-Based Support Save Money While Improving Care?, explored the cost effectiveness of the most recent generation of home and community-based services (HCBS) programs and included the interaction between the Medicare and Medicaid programs, workforce concerns, and the need to better measure effectiveness. Milligan’s presentation, Dual Eligibles in Maryland, gave an overview of Hilltop’s research on cross-payer effects for dual eligibles in Maryland, provided the results of the study, and discussed some implications for policy. To view the presentation, click here. To access the full report, click here.

Hilltop Senior Research Analyst Harriet L. Komisar participated in a meeting for congressional and federal staff hosted by the National Health Policy Forum on June 18, 2010. This meeting, the third of the Focus on Reform series providing an in-depth look at various components of the Patient Protection and Affordable Care Act (PPACA) and related implementation and operational issues, was entitled Long-Term Services and Supports (LTSS) and the CLASS Act. Komisar’s presentation discussed financing sources for LTSS. To view the presentation, click here.

Hilltop Long-Term Supports and Services Director Cynthia H. Woodcock gave a presentation at the National Medicaid Congress pre-conference symposium entitled Managing Current and New Dual Eligibles on June 7, 2010. In the presentation, entitled Dual Eligibles in Nursing Facilities and Other Long-Term Care Settings, Woodcock discussed system coordination issues for dual eligibles in Maryland long-term care settings from a fiscal and service perspective and presented the opportunity for a coordinated care program; described New Mexico’s Coordination of Long-Term Services (CoLTS) program, which Hilltop helped New Mexico develop; and discussed whether coordinated long-term care was more efficient. To view the presentation, click here.

The Hilltop Institute has released a new report entitled, Cross-Payer Effects on Medicare Resource Use: Lessons for Medicaid Administrators. The report, authored by Anthony M. Tucker, PhD, and Karen E. Johnson, MS, is the fourth and final report 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 provides a summary of the initial work of a study, described more fully in the first three reports, with an emphasis on lessons that state Medicaid administrators should consider as they move toward more formal programs of integrated care for persons dually eligible for Medicare and Medicaid (or duals, for short). The view the report, click here. To view the bulletin, click here.

Hilltop Executive Director Charles Milligan participated in a meeting for congressional and federal staff hosted by the National Health Policy Forum on May 7, 2010. This meeting, the first in a new Focus on Reform series providing an in-depth look at various components of the Patient Protection and Affordable Care Act (P.L. 111-148) and related implementation and operational issues, was entitled Medicaid Coverage Expansions. Milligan’s presentation discussed state implementation requirements as well as the opportunities and challenges the coverage expansions present for states. To view the presentation, click here.

On March 24, 2010, Maryland Governor Martin O’Malley signed an Executive Order that created the Health Care Reform Coordinating Council (HCRCC) to make recommendations regarding Maryland’s implementation of the federal health reform legislation. The HCRCC, co-chaired by Lieutenant Governor Anthony Brown and Department of Health and Mental Hygiene Secretary John Colmers, has contracted with The Hilltop Institute to provide analysis and technical assistance throughout the HCRCC’s work, as well as to develop the two reports mandated by the Executive Order. To learn more about the HCRCC, click here.

Hilltop’s work for the Maryland Health Services Cost Review Commission (HSCRC) analyzing Maryland hospitals’ financial assistance and debt collection policies informed the modification of a law enacted in 2009 that requires acute care hospitals to establish state-approved debt collection policies and provide medically necessary care to patients with family incomes below 150% of the federal poverty level (FPL). The legislation, taking effect October 1, 2010, applies the debt collection requirements to chronic care hospitals and requires hospitals to provide reduced-cost care to patients with family incomes below 500% of the FPL if they face financial hardship—medical debt incurred over a 12-month period that exceeds 25% of their income. This legislation will decrease the payment burden for those patients who are struggling financially, thus increasing access to care. Hilltop provided in-depth analyses of these policies and practices, provided consultation to the HSCRC work group that developed the recommendations for the Maryland legislature, and testified before the legislature to discuss its findings. To see the HSCRC report that includes Hilltop’s findings, click here.