The Heroin and Opioid Emergency Task Force, established by Maryland Governor Larry Hogan, recommends that the Maryland Department of Health review Maryland Medicaid rates for substance use disorder (SUD) services every three years. This chart book reviews SUD services provided by the Maryland Medicaid program from CY 2012 to CY 2016 and compares the rates with those of Delaware, Pennsylvania, Virginia, West Virginia, and Washington, DC.

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On March 29, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a final rule on Medicaid and Children’s Health Insurance Programs; Mental Health Parity and Addiction Equity Act of 2008; the Application of Mental Health Parity Requirements to Coverage Offered by Medicaid Managed Care Organizations (MCOs), the Children’s Health Insurance Program (CHIP), and Alternative Benefit Plans (ABPs) (https://www.gpo.gov/fdsys/pkg/FR-2016-03-30/pdf/2016-06876.pdf). This rule provides new requirements for Medicaid and CHIP compliance with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equality Act of 2008 (MHPAEA) and the Affordable Care Act (ACA). Final MHPAEA regulations for group health insurance plans were issued in 2013. Much of this final rule extends the MHPAEA requirements for group health plans to Medicaid MCOs, CHIP, and ABPs, with exceptions and changes as applicable to address the unique aspects of state Medicaid mental health (MH) and substance use disorder (SUD) delivery systems. This document provides a high-level summary of the rule and highlights the changes to the proposed rule.

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Alcohol misuse has been identified as a major public health problem in the United States. However, although not yet widely adopted, alcohol screening and brief intervention (SBI) in the primary care setting has been shown to reduce problematic alcohol consumption.

In order to facilitate SBI for alcohol misuse, Research Circle Associates (RCA), a Maryland-based research firm, obtained a Small Business Technology Transfer (STTR) grant to develop a computerized SBI for use in the primary care setting. The Interventionaire© is a software system used to create and administer patient-based behavioral screening questionnaires and provide normative feedback to patients immediately upon completion of the questionnaire. Following successful proof-of-concept work in Phase I of the STTR, RCA contracted with The Hilltop Institute to conduct a qualitative analysis to address one specific aim of a larger Phase II implementation study: identify staff-perceived barriers to implementing the Interventionaire© in the primary care setting.

This report not only identifies staff-perceived barriers to implementing a computerized alcohol SBI tool in a primary care setting, but also identifies potential facilitators and explores anticipated advantages and disadvantages to implementation.

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At the request of the Maryland Department of Health and Mental Hygiene (DHMH), The Hilltop Institute conducted a series of analyses on the health care utilization of Maryland’s full-benefit Medicare-Medicaid dual-eligible beneficiaries. Together, these analyses provide an overview of how this population accesses health care services, the types of services being used, and where the services are provided.

This report examines full-benefit dual-eligible beneficiaries with mental health conditions in Maryland during calendar year (CY) 2012, including number and type of mental health conditions; demographics and county of residence; emergency department use; and Medicare and Medicaid expenditures and service days.

Related publications: Maryland Full-Benefit Dual-Eligible Beneficiaries’ Use of Medicare and Medicaid Services Preceding and Following a Medicare Inpatient Stay, Characteristics of Maryland Full-Benefit Dual-Eligible Beneficiaries with Three or More Inpatient Stays, and The Maryland Dual-Eligible Beneficiaries Chart Book.

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The purpose of this report is to fulfill the Maryland General Assembly’s request for an evaluation describing the outcomes of participants in the Maryland Health Home program. Maryland’s Health Home program targets Medicaid participants with a serious and persistent mental illness (SPMI) and/or an opioid substance use disorder (SUD) and risk of additional chronic conditions due to tobacco, alcohol, or other non-opioid substance use and children with serious emotional disturbances (SED).

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Hilltop staff made several presentations at the 2015 AcademyHealth Annual Research Meeting (ARM) held June 13 through June 15 in Minneapolis. Senior Policy Analyst Shamis Mohamoud, MA, delivered this podium presentation at the State Health Research and Policy Interest Group Meeting.

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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.

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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.

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The incidence of mental health disorders co-occurring with chronic somatic health conditions is gaining attention. This combination can pose significant burdens to health care system resources to provide for complex care needs. Using the Centers for Medicare and Medicaid Services Chronic Condition Data Warehouse, Hilltop explored the prevalence of co-occurring mental health disorders amongst Maryland’s new dual eligible enrollees during 2008 and their subsequent Medicare and Medicaid resource use. This report presents Hilltop’s findings, which establish the scope of the prevalence of mental health conditions among new dual eligible enrollees in Maryland and highlight the need for greater attention and research into this population.

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This report, mandated by the Maryland legislature, was originally intended to be a cost analysis that would provide the basis for a financial subsidy to encourage the expansion of Medicare+Choice plans across Maryland. However, the study took a more comprehensive approach to describe the national and state context in which Medicare+Choice withdrawals were occurring and the impact of the withdrawals on consumers and health care programs.

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Hilltop continues to work remotely, so please reach us by email. You can find our team members’ email addresses by going to their bios located on the Teams page of our website.