Health Services Policy and Research
What We Do: The Hilltop Institute is nationally recognized for its research on publicly funded health care services, including Medicaid and Medicaid managed care. Hilltop's analyses include, but are not limited to, service access and utilization, cost effectiveness, and provider participation. Most recently, Hilltop has analyzed dental care, behavioral health care, well-child visits, and emergency services, and has worked on behalf of such vulnerable populations as children in foster care, persons addicted to heroin, and persons with co-occurring substance abuse and mental health disorders.
Hilltop collaborated with the Maryland Department of Health and Mental Hygiene to establish HealthChoice, Maryland's Medicaid managed care program, in 1997. This program currently serves nearly ½ million Marylanders. Hilltop assisted the Department with the preparation of the initial federal waiver and drafting of regulations for the program. Hilltop also provided the analysis supporting the waiver for the Maryland Children's Health Program (MCHP), part of HealthChoice. Hilltop reviews applications from managed care organizations (MCOs) for participation in HealthChoice and monitors MCO performance on both quality measures and financial indicators. Hilltop assisted MCOs in their progression towards HIPAA-compliant electronic format files and plays an active role in the assessment of changes required in the Medicaid management information system. Hilltop is a key contributor to the HealthChoice evaluation and prepares evaluation updates annually. Hilltop is presently working with the Department to examine ways to better coordinate physical health services with mental health services for clients of HealthChoice.
Through Hilltop's efforts, Maryland has become a national leader in the collection and validation of MCO encounter data. Hilltop provided technical assistance to the state of Massachusetts on encounter data collection and maintenance. Managed care encounter data continue to be a valuable source for monitoring MCO performance, evaluating health services utilization, and analyzing racial disparities in access to care.
Hilltop works with state, regional and local public health agencies to assist in the development and expansion of state insurance coverage initiatives and health services systems; and in the evaluation of healthcare reform efforts. Hilltop also worked with safety net providers to analyze reimbursement and sustainability strategies.
How We Can Help: Hilltop assists states in implementing Medicaid managed care programs, monitoring MCO performance, analyzing service utilization, identifying access barriers, and evaluating the quality, affordability, and sustainability of publicly funded healthcare services. Hilltop also has expertise in the analysis of the administrative efficiency for health programs and systems. In addition, analyses conducted by Hilltop inform policy development regarding the options for publicly funded healthcare.
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