Senior Policy Analysts Laura A. Spicer, MA, and Charles Betley, MA, gave this presentation at a Continuity of Care Advisory Committee Meeting. The Committee was appointed by the Board of Trustees in June of 2012 to begin addressing the transition between Medicaid, the state-based exchange and the commercial market.
Hilltop made several presentations at the 65th Annual Scientific Meeting of the Gerontological Society of America that took place November 14-18, 2012, in San Diego. On November 14, Hilltop presented a symposium session titled Medicare-Medicaid Enrollees: An Examination of New Maryland Enrollees and Pathways to Coverage. The purpose of the session was to discuss the findings of the research Hilltop conducted to examine the experience of Maryland Medicare-Medicaid enrollees before their eligibility for both programs. The research identified and cataloged significant differences between persons who first enroll in Medicaid and then in Medicare and those who first enroll in Medicare and then in Medicaid. In the session, Hilltop researchers shared the results of their analyses and findings from a background paper about pathways to eligibility for both programs. Hilltop Director of Long-Term Services and Supports Policy and Research Donna Folkemer, MA, moderated the session. Cynthia Woodcock, MBA, formerly of Hilltop and now Practice Area Lead, Long-Term Care, Aging, and Disability at IMPAQ International, discussed the literature review that described the various pathways to eligibility, presented examples of programs aimed at delaying functional decline and/or poverty, and reviewed enrollment barriers faced by individuals who need both Medicare and Medicaid coverage. Hilltop Policy Analyst Aaron Tripp, MSW, discussed the study on demographic and programmatic characteristics, which compared and contrasted enrollees in both programs with particular attention to identifying differences among various groups. Hilltop Director of Special Studies Ian Stockwell, MA, discussed the study on prior Medicare and Medicaid resource use, which examined chronic disease patterns and prior health care expenditures of persons who began to receive coverage in 2008 from both Medicare and Medicaid. Chuck Milligan, JD, MPH, Maryland Department of Health and Mental Hygiene Deputy Secretary of Health Care Financing, was the discussant for the session.
This issue brief highlights key findings from Hilltop’s study that evaluated the Kids First outreach initiative. The overarching goal of the study was to evaluate the implementation of Kids First and how well the state achieved its goal of identifying and enrolling uninsured children who are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) in order to glean lessons for not only Maryland, but also other states. This brief describes the factors that facilitated Kids First, as well as the key challenges that Maryland faced as it implemented the initiative.
HealthChoice, Maryland’s statewide mandatory Medicaid managed care program, was implemented in 1997 under authority of Section 1115 of the Social Security Act. The HealthChoice managed care program currently enrolls over 80 percent of the state’s Medicaid population. The program also enrolls children in the Maryland Children’s Health Program (MCHP), Maryland’s Children’s Health Insurance Program (CHIP). Since the program’s inception, the Maryland Department of Health has conducted four comprehensive evaluations as part of the 1115 waiver renewals. Between waiver renewals, the Department continually monitors HealthChoice performance on a variety of measures and completes an annual evaluation for HealthChoice stakeholders. This report is the 2011 annual evaluation of the HealthChoice program.
The Hilltop Institute developed a Health Care Reform Simulation Model, a financial modeling tool that projects the costs and savings of implementing the provisions of the Affordable Care Act (ACA), for the state of New Mexico. The basic approach of the simulation model developed for New Mexico was to compare the new costs and savings associated with health care reform with a baseline assumption of what those costs and savings would have been in the absence of reform.
This is a user’s guide for the fiscal model.
For this guide, we have assumed that model users have read the document, New Mexico Health Care Reform Fiscal Model: Detailed Analysis and Methodology, and are familiar with the methods of analysis that were used to develop the fiscal model.
The Hilltop Institute developed a Health Care Reform Simulation Model, a financial modeling tool that projects the costs and savings of implementing the provisions of the Affordable Care Act (ACA), for the state of New Mexico. The basic approach of the simulation model developed for New Mexico was to compare the new costs and savings associated with health care reform with a baseline assumption of what those costs and savings would have been in the absence of reform.
This report provides a detailed analysis and methodology of the modeling tool.
This report describes and analyzes chronic disease patterns and health care expenditures of persons in Maryland who in 2008 began to receive coverage from both Medicare and Medicaid (Medicare-Medicaid enrollees). The analysis focuses on disease and expenditure patterns in the year before these individuals, most of whom had been enrolled in Medicare alone or Medicaid alone, became enrollees in both programs. Examining health status and expenditures of individuals before their eligibility for both programs can provide a better understanding of the characteristics associated with simultaneous enrollment in Medicare and Medicaid.Also under Task 20 of CMS Contract HHSM-500-2005-00026I/Task Order HHSM-500-T0004, awarded by the Centers for Medicare & Medicaid Services to Thomson Reuters (Healthcare) Inc., Hilltop prepared Pathways to Medicare-Medicaid Eligibility: A Literature Review and New Medicare-Medicaid Enrollees in Maryland: Demographic and Programmatic Characteristics.
This study, which focuses on new Medicare-Medicaid enrollees in Maryland and the circumstances that shaped their initial eligibility for both programs, is an attempt to begin to address several of the gaps identified in a prior literature review. This report details the demographic and programmatic characteristics of new enrollees. Specifically, it serves as the vehicle for establishing an initial operational definition of new enrollees and developing the terminology needed to describe the circumstances surrounding initial Medicare-Medicaid eligibility.Also under Task 20 of CMS Contract HHSM-500-2005-00026I/Task Order HHSM-500-T0004, awarded by the Centers for Medicare & Medicaid Services to Thomson Reuters (Healthcare) Inc., Hilltop prepared Pathways to Medicare-Medicaid Eligibility: A Literature Review and New Medicare-Medicaid Enrollees in Maryland: Prior Medicare and Medicaid Resource Use.
This paper, prepared for the National Governors Association, discusses the progress states have made in moving away from institutional care for Long-Term Supports and Services and toward home and community-based programs. It analyzes the opportunities available through the Affordable Care Act and other programs whereby states can continue that progress even in a challenging budget environment.
The Affordable Care Act (ACA) requires states to either establish and operate a Health Insurance Exchange by 2014 or participate in the federal Exchange. On April 12, 2011, Governor O’Malley signed the Maryland Health Benefit Exchange Act of 2011, which established Maryland’s Exchange as an independent unit of the state government. The Act also established a Board of Trustees to oversee the Exchange. The Hilltop Institute was commissioned to develop a series of background papers in order to assist the Board in planning for the implementation of Maryland’s Exchange.This presentation, delivered by Senior Policy Analyst Martha Somerville, JD, MPH, discusses the background paper on health benefit plan contracting.