This is the first chart book in a series that explores utilization and expenditures for Medicaid-funded LTSS in Maryland for state fiscal year (FY) 2014 through FY 2018. The focus of this chart book is on Medicaid nursing facility services, with one chapter that illustrates Maryland’s efforts at providing home and community-based services (HCBS)* to an increasing number of Medicaid recipients who may otherwise be served in nursing facilities.
As directed by the 2020 Joint Chairmen’s Report from the Maryland General Assembly, Hilltop, in consultation with the Maryland Department of Health, examined Maryland’s Home and Community-Based Options Waiver (CO Waiver), established in 2014 through a merger of the Waiver for Older Adults and the Living at Home Waiver. To address the Joint Chairmen’s request, Hilltop conducted this five-part study.
This report describes the services The Hilltop Institute provided to the Maryland Department of Health (the Department) under the Master Agreement between Hilltop and the Department. The report covers fiscal year (FY) 2020 (July 1, 2019, through June 30, 2020). Hilltop’s interdisciplinary staff provided a wide range of services, including: Medicaid program development and policy analysis; HealthChoice program support, evaluation, and financial analysis; long-term services and supports program development, policy analysis, and financial analytics; and data management and web-accessible database development.
This chart book—from a series that explores service utilization and expenditures for Medicaid-funded long-term services and supports in Maryland—summarizes data for Autism Waiver participants for fiscal year (FY) 2013 through FY 2017.
This chart book is the second in a series that explores utilization and expenditures for Medicaid-funded long-term services and supports (LTSS) in Maryland for state fiscal years (FYs) 2014 through 2018. The focus of this chart book is on Medicaid HCBS, with one chapter dedicated to illustrating Maryland’s efforts at providing these services to an increasing number of Medicaid recipients who may otherwise be served in institutions. Medicaid programs and services addressed in this chart book include the following: the Home and Community-Based Options (CO) Waiver, Community First Choice (CFC), Community Personal Assistance Services (CPAS), Medical Day Care Services (MDC) Waiver, Money Follows the Person (MFP), and Medicaid nursing facility services.
The Maryland Primary Care Program (MDPCP) is a key element of the Total Cost of Care (TCOC) All-Payer Model, an agreement between the Centers for Medicare & Medicaid Services (CMS) and the state of Maryland. The MDPCP is a voluntary program that provides funding and support for the delivery of advanced primary care throughout the state. It allows primary care providers to play an increased role in the prevention and management of chronic disease, as well as in the prevention of unnecessary hospital utilization.
As an important part of supporting providers in their care management efforts, the MDPCP will provide to participating practices risk scores of their attributed beneficiaries according to each patient’s risk of incurring a potentially avoidable hospitalization or emergency department (ED) visit. Accordingly, The Hilltop Institute, in conjunction with the Maryland Department of Health, has developed the Hilltop Pre-AH (Predicting Avoidable Hospitalizations) Model™ in order to operationalize these risk scores. These patient-level risk scores are provided to participating medical practices on a monthly basis via the MDPCP portal on the Chesapeake Regional Information System for our Patients (CRISP) unified landing page.
This document aims to explain the intended use, technical implementation, and model performance of the Hilltop Pre-AH Model™ as of June 2020. It will be updated as future versions of the model become operational.
DCM interventions improve glycemic control and readmission. Cost effectiveness studies typically use only system EHR data. We implemented a 3-month technology-enabled DCM intervention (Diabetes Boot Camp (DBC)) for adults with uncontrolled T2DM in a regional health system. Using EHR data, DBC was shown to reduce A1C and hospitalizations compared to matched controls. The aim of this study was a TCOC assessment of DBC among Medicaid participants using claims data.
Laura Spicer and Charles Betley were co-authors of this article published in Diabetes.
People with dementia (PWD) represent some of the highest-need and highest-cost individuals living in the community. Maximizing Independence (MIND) at Home is a potentially cost-effective and scalable home-based dementia care coordination program that uses trained, nonclinical community workers as the primary contact between the PWD and their care partner, supported by a multidisciplinary clinical team with expertise in dementia care. This study calculated cost of care management services based on actual time spent by care management personnel over the first 12 months of the MIND at Home intervention for 342 MIND at Home recipients from Baltimore, Maryland and surrounding areas participating in a Centers for Medicare and Medicaid Services (CMS)-funded Health Care Innovation Award demonstration project.
Ian Stockwell, PhD, co-authored this article published in Innovation in Aging.
This report describes the services The Hilltop Institute provided to the Maryland Department of Health (the Department) under the Master Agreement between Hilltop and the Department. The report covers fiscal year (FY) 2019 (July 1, 2018, through June 30, 2019). Hilltop’s interdisciplinary staff provided a wide range of services, including: Medicaid program development and policy analysis; HealthChoice program support, evaluation, and financial analysis; long-term services and supports program development, policy analysis, and financial analytics; and data management and web-accessible database development.
This chart book—from a series that explores service utilization and expenditures for Medicaid-funded long-term services and supports in Maryland—summarizes data for Brain Injury Waiver participants for fiscal year (FY) 2013 through FY 2017.