Policy Analysis

Harbage Consulting has deep expertise in policy analysis and program implementation at the federal, state, and local levels. We specialize in translating complex regulations and legislation into digestible materials tailored to our clients’ needs. We work closely with our clients to ensure that they have the support and information they need for effective decision making.

In our work with states, we conduct research and analysis on particular policy issues and provide recommendations and options for consideration. This work often involves providing Medicaid policy consulting and strategic advice on:


  • Section 1115 waiver development
  • Behavioral health policy
  • Maternal and child health issues
  • Care coordination
  • State and federal rules and priorities


Harbage Consulting also frequently develops policy papers for publication. See Our Publications for more information.

Click on the projects below to learn more about our work.

Vision to Learn

Since 2016, Harbage Consulting has worked with the national Vision to Learn program and the Baltimore City Health Department to expand access to and utilization of vision screening and exam services. Our team conducted multiple policy and legal analyses of key issues for the program, including:


  • Identifying effective strategies for getting parental consent to provide vision exams for students;
  • Ensuring that Medicaid is billed appropriately and effectively for services provided; and
  • Assessing Family Educational Rights and Privacy Act (FERPA) and Health Insurance Portability and Accountability (HIPAA) privacy and data security requirements for all aspects of the program.


We provided Vision to Learn with analyses of several issues related to information-sharing and interactions between school districts and public health departments in Maryland, Michigan, California and North Carolina. The Baltimore project concluded with a memo outlining options and recommendations for ensuring the long-term sustainability of the Vision for Baltimore program.

Maternal and Child Health in Baltimore

Since 2015, Harbage Consulting has supported the Baltimore City Health Department on two initiatives designed to promote maternal and child health and reduce infant mortality rates. In this capacity, Harbage Consulting:


  • Conducted in-depth policy analysis on the structure of the B’More for Healthy Babies initiative and identified opportunities for the Medicaid program to provide federal financial support;
  • Provided recommendations to the health department and to the State of Maryland on opportunities to promote the sustainability of B’More for Healthy Babies, including through Medicaid coverage of home-visiting services for pregnant women and new mothers; and
  • Assessed and identified policy and operational improvements for the Baltimore Infants and Toddlers Program, including recommending strategies for ensuring that Medicaid is billed appropriately for services provided.

Louisiana Medicaid Expansion

As the State of Louisiana prepared to implement the Affordable Care Act’s Medicaid expansion in July 2016, Harbage Consulting conducted an analysis of the state’s eligibility system and program rules and provided a set of recommendations for ensuring that individuals who now have Medicaid coverage in Louisiana can stay enrolled for as long as they are eligible. We provided the Louisiana Association of Health Plans with a series of options and recommendations that the Medicaid health plans and the state Department of Health and Hospitals could adopt in order to achieve an effective eligibility renewal process for Medicaid.


Louisiana worked in partnership with the health plans to adopt a number of our recommendations, including implementing a system for real-time data sharing and using text messaging to provide personalized reminders to Medicaid enrollees about the importance of renewing their coverage each year.

SAMHSA Mental Health Continuum of Care

Beginning in 2017, Harbage Consulting has been working with the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop a national continuum of care for adults with a serious mental illness (SMI).


The goal of the project is to identify a core set of evidence-based services that should be available to adults with SMI, regardless of their state and source of health insurance coverage. We conducted a literature review of behavioral health continuum of care models and services and developed a proposed SMI continuum of care that is being discussed with national experts and stakeholders. The project will culminate in a SAMHSA white paper with a recommended continuum of care for adults with SMI, as well as a dissemination and adoption plan.

For more information on our work in this area, see our Case Study.

At the intersection of health care policy, politics and communications.