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.
Charles Milligan delivered this presentation to two groups—Ohio state legislators and their staff, and other stakeholders—at a legislative briefing sponsored by the Health Policy Institute of Ohio. In this briefing, Milligan gave an overview of Medicaid and discussed budget tools used by states to manage Medicaid programs, which are important for lawmakers to understand when developing and assessing budget and program proposals. Milligan also addressed the implications of federal health reform for state Medicaid programs and the changing state/federal relationship.
With the growing role of home and community-based services (HCBS) in Medicaid long-term services and supports (LTSS), it is important to have a clear understanding of the different characteristics of the population transitioning from institutional care to HCBS, the trends occurring in LTSS over time, and the effect of the different programs. This resulted in Hilltop developing a series of metrics that were first presented to the Maryland Money Follows the Person (MFP) Stakeholder Advisory Group and are now available here in the form of chart books. These metrics can be tailored for any state to guide program development, explore other aspects of its LTSS system (such as opportunities for cost savings and program efficiency), and target populations for outreach efforts. This chart book summarizes the key findings of these metrics.
Also in this series are: Institutional Utilization and Transitions,The Institutional Characteristics of Transitioned Individuals, The Service Use and Cost of Transitioned Individuals, and a The Quality of Life Survey Responses.