On January 18, 2006, the Center will convene Ian Axford fellows and invited guests at UMBC for a one-day forum. Established in 1995, the Ian Axford Fellowships in Public Policy give outstanding American professionals opportunities to study, travel, and gain practical experience in public policy in New Zealand . Health care, the environment, taxes, ethnic diversity, and education are but a few of the topics that Axford fellows have investigated. The program has provided a unique opportunity to American policy professionals to engage in innovative thinking and explore diverse policy perspectives on a wide variety of topics.
This will be the first time that Axford fellows have come together. The agenda for the forum features presentations by the three 2005 Axford fellows who have recently returned to the United States.
- Dena Ringold of the World Bank examined how programs might be tailored to better address the range of disparities faced by indigenous peoples and other vulnerable populations, such as the 15 percent of New Zealanders who are also Maori.
- Nick Johnson of the Center on Budget and Policy Priorities studied New Zealand ‘s Working for Families program. He explored the relationship between fiscal and tax policy in meeting the needs of low-income populations while promoting efficient labor markets.
- John O’Brien of the Center for Health Program Development and Management at UMBC investigated the complexities of measuring and rewarding performance in health care delivery systems.
Former Axford fellows will serve as responders, and the program will be placed in context with remarks by Robert Reischauer , President of The Urban Institute and former chair of the Ian Axford Fellowships selection committee; John Wood , New Zealand Ambassador to the United States; Annette Dixon , the World Bank’s Director of Strategy and Operations for Europe and Central Asia Region; and Peter Watson , CEO of the Dwight Group and current chair of the Axford selection committee. Discussion among forum participants is expected to generate fresh insights and novel approaches to public policy that otherwise might not be considered.
Academy Health has commissioned an issue brief entitled “Turning Medicaid Beneficiaries into Purchasers of Health Care: Critical Success Factors for Medicaid Consumer-Directed Health Purchasing.” It will examine factors states should consider when launching Medicaid reforms such as those proposed in Florida, South Carolina, and West Virginia. The Center is collaborating with Academy Health’s State Coverage Initiatives, a program of The Robert Wood Johnson Foundation, to prepare the issue brief.
Chuck Milligan, executive director of the Center for Health Program Development and Management, delivered these presentations to the federal Medicaid Commission at its meeting in Washington on October 26-27, 2005:
Medicaid Eligible Populations
The Medicaid Acute Care Delivery System
The Medicaid Long-Term Care Delivery System
Quality and Information Technology in Medicaid
Medicaid Program Administration – Financing, IT, and Fraud and Abuse
On August 17, 2005, Chuck Milligan , executive director of the Center for Health Program Development and Management, delivered a presentation to the Medicaid Commission. This presentation provided background information on the requirements and restrictions in the Medicaid program, and it touched on where flexibility does and does not presently exist.
On June 28, 2005, Chuck Milligan, executive director of the Center for Health Program Development and Management, testified to the Senate Finance Committee at the invitation of Senator Charles Grassley, committee chairman. Mr. Milligan discussed state Medicaid financing arrangements, such as intergovernmental transfer (IGT) and upper payment limit (UPL) arrangements that involve public hospitals and nursing facilities, as well as Medicaid school-based reimbursement. Click here for Mr. Milligan’s written testimony and here for his oral testimony.
Home- and community-based services waiver programs enable many individuals dually eligible for Medicare and Medicaid to avoid nursing homes. But access to prescription drugs may be impeded when drug coverage is transferred from Medicaid to Medicare in January 2006, threatening the ability of dual eligibles to remain in the community. The Center examined the likely impact of the new Medicare drug benefit in Maryland and recommends federal policy remedies.
In a Medicaid study required by Michigan’s legislature, the Center evaluated whether capitated managed care involving multiple managed care organizations (MCO) is cost effective, when compared to three alternative delivery systems: fee-for-service, primary care case management, and a capitated managed care program involving a single statewide MCO. The Center’s analysis concluded that the state of Michigan would save between $28 million and $129 million in state funds in FY 2006 when the current capitated program involving multiple MCOs is compared to all of the alternative delivery systems. The exact amount of savings that Michigan will achieve depends on the size of the managed care rate increase in FY 2006, and on which alternative delivery system is under consideration.
The Center is pleased to announce a new partnership with the New Mexico Human Services Department and New Mexico State University. The Center will assist New Mexico in developing and evaluating new Medicaid policies and programs. Initial work will focus on consumer-directed services and managed long-term care.
As Medicaid managed care programs mature, states are looking to refine their methods for measuring and improving the performance of participating health plans. This report serves as a guide for Medicaid agencies who want to develop a performance measurement program using administrative data to evaluate the care provided to enrollees with chronic diseases. The report identifies potential performance indicators that are associated with improved medical outcomes and demonstrates the application of diagnosis-based risk adjustment to performance measurement by profiling six health plans.