Below is a listing of select Hilltop publications and presentations. You can search by type, topic, date, and/or title. The search function searches for key words in both the title and the publication summary. Click on the publication’s title below to go to its summary.
Accessibility Notice: Publications released before April 24, 2026 have not been remediated for Section 508 compliance.
The Hilltop Pre-HE Model—which generates the rankings for the Hospice Eligibility and Advanced Care Planning (Pre-HE) scores—is designed to support proactive advanced care planning discussions by estimating a patient’s risk of eligibility for hospice. The Pre-HE Model provides risk scores and reasons for risk for all attributed beneficiaries of Maryland Primary Care Program (MDPCP) practices every month in order to identify patients that are potentially appropriate for hospice care and to provide care teams with information that can guide the sensitive and difficult conversations about end-of-life care with patients and their families.
The Hilltop Pre-DC Model—which generates the rankings for the Severe Diabetes Complications (Pre-DC) scores—is designed to facilitate the active management of type 2 diabetes by estimating individuals’ risk of incurring inpatient admissions or emergency department (ED) visits for severe diabetes complications. The Pre-DC Model provides risk scores and reasons for risk for all attributed beneficiaries of Maryland Primary Care Program (MDPCP) practices every month to help care teams proactively identify high-risk individuals and allocate scarce care management resources.
The Hilltop Pre-AH Model—which generates the rankings for the Avoidable Hospitalizations (Pre-AH) scores—is designed to assist providers by allowing them to easily identify patients at a high risk of incurring an avoidable inpatient hospitalization or emergency department (ED) visit. The Pre-AH Model provides risk scores and reasons for risk for all attributed beneficiaries of Maryland Primary Care Program (MDPCP) practices every month to help care teams make informed decisions about how to direct scarce care coordination resources to the individuals who will benefit from them the most.
This document summarizes the answers to frequently asked questions about the Hilltop Pre- Model risk scores that are available in the Maryland Primary Care Program (MDPCP) and Multi-Payer CRISP reporting suites—Avoidable Hospital Events (Pre-AH), Severe Diabetes Complications (Pre-DC), and Hospice Eligibility (Pre-HE). It covers information related to the meaning of each of the risk scores, the differences between them, how they are intended to be used, their predictive performance, and where to go to find more information.
The Maryland Department of Health (Department) is responsible for evaluating the quality of care provided to eligible enrollees by contracted managed care organizations (MCOs) through the Maryland Medicaid Managed Care Program, known as HealthChoice. HealthChoice operates under a Centers for Medicare & Medicaid Services (CMS) 1115 waiver of the Social Security Act and Code of Maryland Regulations (COMAR) to serve Marylanders on Medicaid. Guiding principles for HealthChoice’s operations are to provide quality healthcare that is equitable, patient-focused, prevention-oriented, coordinated, accessible, and cost-effective.
Federal regulations require the Department to contract with an external quality review organization (EQRO) to provide annual, independent reviews for assessing quality, access, and timeliness of care. This independent review ensures services provided to enrollees meet the standards governing the HealthChoice program in the Code of Federal Regulations (CFR) and COMAR. The Department contracts with Qlarant to meet federal regulations; evaluate quality, access, and timeliness of care; and validate encounter data.
Hilltop performed Activity 3 of this evaluation, which is included in Appendix A of Qlarant’s report.
This report describes the services The Hilltop Institute provided to the Maryland Department of Health under their Master Agreement. The report covers fiscal year (FY) 2025 (July 1, 2024, through June 30, 2025). 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 annual report, written for the UMBC community, provides an overview of key projects and staff accomplishments for FY 2025.
In 1997, Maryland implemented HealthChoice—a statewide mandatory Medicaid and Children’s Health Insurance Program (CHIP) managed care program—under authority of a waiver through §1115 of the Social Security Act. The provisions of the Affordable Care Act (ACA) that went into effect in 2014 marked another milestone by extending quality coverage to many more Marylanders with low income. Over 25 years after its launch, HealthChoice covers close to 90% of the state’s Medicaid and Maryland Children’s Health Program (MCHP) populations. Since the inception of HealthChoice, the Maryland Department of Health (the Department) has requested and received seven §1115 waiver renewals.
The Hilltop Institute, on behalf of the Department, evaluates the program annually; this evaluation covers the period of calendar year (CY) 2019 through CY 2023.
The Hilltop Institute has released updated analysis of the Medicaid provider tax provisions of the Senate budget reconciliation bill. The estimates, which model the version of the bill released from the Senate Finance committee on June 16, 2025, update Hilltop’s earlier analysis of provider taxes. Authored by Hilltop Director of Analytics & Research Dr. Morgan Henderson, Senior Data Scientist Dr. Leigh Goetschius, and Executive Director Alice Middleton, this analysis uses hospital provider tax rates and net patient revenue data to calculate the estimated state-level impacts of the proposed Senate legislation. The authors find that, once the provider tax reductions are fully implemented as of 2031, this legislation would reduce federal funding to 18 Medicaid expansion states by over $11.9 billion annually. Moreover, the impact will not be uniform: the impact will be largest in states with high hospital provider tax rates. Specifically, the authors find that Arizona, New Hampshire, Nevada, Iowa, Vermont, and Michigan would each at lose least 7.5% of their federal Medicaid funding as a result of this bill.
While the proposed legislation proposes a suite of Medicaid policy changes that would interact in various ways, this analysis only considers the hospital provider tax change in isolation. This is the latest in a series of Hilltop analyses focused on modeling state-level impacts of potential federal Medicaid policy changes.
The Maryland Medicaid Dental Program Chart Book outlines the demographics and service utilization for individuals enrolled in the Maryland Medicaid Dental Program. This chart book provides information about program participants who received services in calendar year (CY) 2019 through CY 2023.