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 background paper provides information on Navigator programs that, as defined by the ACA, provide public education and awareness about, distribute fair and impartial information about, and facilitate enrollment in qualified health plans. The background paper is also intended to provide foundational support for a formal study conducted on the design and operation of the Exchange’s Navigator Program and other appropriate consumer assistance mechanisms.
The Hilltop Institute conducted a literature review on pathways to Medicare-Medicaid eligibility at the request of the Medicare-Medicaid Coordination Office (MMCO) within the Centers for Medicare and Medicaid Services (CMS). This work was performed under Task Order RTOP CMS-10-022 awarded to Thomson Reuters (Healthcare), Inc., in 2010.Hilltop also prepared New Medicare-Medicaid Enrollees in Maryland: Demographic and Programmatic Characteristics and New Medicare-Medicaid Enrollees in Maryland: Prior Medicare and Medicaid Resource Use.
This report, which was presented at the Long-Term Care Interest Group Colloquium at the June 2011 AcademyHealth Annual Research Meeting in Seattle, Washington, discusses progress in rebalancing Medicaid long-term services and supports (LTSS) spending, how the Affordable Care Act can support states’ continued efforts to rebalance LTSS, and opportunities for future research to support continued system transformation.To access the presentation on this topic, click here.
At the AcademyHealth Annual Research Meeting (ARM), Hilltop Director of Long-Term Services and Supports Cynthia H. Woodcock, MBA, and Maryland Department of Health and Mental Hygiene Deputy Secretary of Finance and former Hilltop Executive Director Charles J. Milligan, Jr., JD, MPH, presented this keynote address at the Long-Term Care Colloquium. Woodcock and Milligan presented highlights from their invited paper focusing on the success, to date, of rebalancing long-term care toward community settings and the implications of provisions in the Affordable Care Act for future rebalancing efforts.To access the invited paper, click here.
At the AcademyHealth Annual Research Meeting (ARM), Hilltop Director of Medicaid Policy Studies David Idala, MA, gave a presentation at a session on outreach and enrollment that examined how states could reach newly eligible populations under the Affordable Care Act (ACA). His presentation discussed the use of state income tax forms to identify children who are eligible for, but not enrolled in, Medicaid, and the lessons learned so far from the Maryland Kids First outreach initiative that could help states as they implement the ACA.
At the AcademyHealth Annual Research Meeting (ARM), Hilltop Policy Analyst Laura Spicer gave a presentation at a session on Addressing Cost and Affordability in Public Programs: Implications for the Affordable Care Act. Her presentation discussed findings from a Hilltop study funded by the Robert Wood Johnson Foundation’s State Health Access Reform Evaluation (SHARE) initiative. The study identified factors associated with small group employer participation in New Mexico’s State Coverage Insurance (SCI) program.
At the AcademyHealth Annual Research Meeting (ARM), Hilltop Senior Policy Analyst Karen E. Johnson, MS, gave this poster presentation, which was also authored by Hilltop Director of Special Research and Development Anthony M. Tucker, PhD, and UMBC Assistant Professor Yi Huang, PhD. The poster described the use of a propensity score matching methodology to identify comparison groups among Medicare-Medicaid beneficiaries who received Medicaid-paid long-term services and supports (LTSS) via home and community-based (HCBS) waivers versus those who did not receive LTSS. This matching technique was used to establish comparable treatment/control pairs for subsequent analysis of cross-payer effects of providing Medicaid-paid LTSS on Medicare acute care resource use, and could be used more generally to strengthen policy analyses that are based on observational and/or administrative data.
Many of the opportunities made available by the Affordable Care Act (ACA) can be leveraged to work together and to build on existing initiatives. The result can be a strengthened infrastructure for service provision and a long-term services and supports (LTSS) system that can better meet the needs of Medicaid beneficiaries. This National Association of States United for Aging and Disabilities (NASUAD) issue brief, written by Hilltop Director of LTSS Policy and Research Cynthia H. Woodcock, MBA, summarizes key provisions of the ACA and considerations for states seeking to take advantage of these new opportunities.
Hilltop Deputy Director Michael Nolin participated in a panel discussion entitled Health Reform 2011: Where are we now? at the Annual Meeting of the American Society of Public Administrators on March 14, 2011, in Baltimore, Maryland. In his presentation, which focused on Maryland’s reform efforts, Nolin gave an overview of Maryland’s reform preparation process and described the Maryland Health Care Reform Coordinating Council (HCRCC) and the work Hilltop performed as staff for the HCRCC; described Hilltop’s financial modeling tool that determined that Maryland could save $829 million in implementing federal health reform; and discussed the major health reform issues that remain unresolved.
Charles Milligan gave a presentation on opportunities to better serve dual eligiles to the Ohio Association of Health Plans and the Ohio Association of Area Agencies on Aging (O4A). He discussed the importance of integrating long-term services and supports for this population; the results of Hilltop’s research on Medicare/Medicaid cross-payer effects for dual eligibles that found that Medicare and Medicaid financing do not align to promote home and community-based services (HCBS) and that the HCBS waiver is only cost-effective (at the individual level) for Medicaid when it truly avoids a nursing home placement; and new opportunities for states under the Affordable Care Act to better serve dual eligibles.