This report is the fourth and final report in a series that explores the cross-payer effects of providing Medicaid long-term supports and services (LTSS) on Medicare acute care resource use. The report provides a summary of the initial work of a study, described more fully in the first three reports, with an emphasis on lessons that state Medicaid administrators should consider as they move toward more formal programs of integrated care for persons dually eligible for Medicare and Medicaid (or duals, for short).

Also in this series are: A Framework for State-Level Analysis of Duals: Interleaving Medicare and Medicaid Data, A Framework for State-Level Analysis of Duals: Interleaving Medicare and Medicaid Data–Poster Presentation, Examining Rate Setting for Medicaid Managed Long-Term Care, and Examining the Medicare Resource Use of Dually Eligible Medicaid Recipients.

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The Hilltop Institute carried out a resource mapping project for the state of Rhode Island as part of the state’s efforts to create a more accessible system of long-term services and supports under their federal Real Choice Systems Transformation grant. Hilltop interviewed state agency staff on their perceptions of service gaps and barriers to accessing the system of long-term services and supports; conducted a survey of providers of long-term services and supports in the state about current and future capacity to serve Rhode Islanders; and constructed a rebalancing model for projecting utilization and expenditures for Medicaid long-term services and supports through 2030. This report presents the results of these efforts.

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The Hilltop Institute constructed a rebalancing model for the state of Rhode Island as part of the state’s efforts to create a more accessible system of long-term services and supports (LTSS) under their federal Real Choice Systems Transformation grant. This presentation provides an overview of the rebalancing model, which projects utilization and expenditures for Medicaid LTSS through 2030.

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The Hilltop Institute carried out a resource mapping project for the state of Rhode Island as part of the state’s efforts to create a more accessible system of long-term services and supports under their federal Real Choice Systems Transformation grant. This presentation provides an overview of Hilltop’s final report for the project.

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This fact sheet provides an overview of Medicaid long-term services and supports in Maryland. It includes information on demographic trends, home and community-based services waivers, expenditures, and dual eligibles.

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Hilltop Medicaid Policy Studies Director David Idala, MA, discussed Maryland’s strategy for targeting public program enrollment efforts at a webinar hosted by the State Health Access Reform Evaluation (SHARE) on February 24, 2010, entitled Using Income Tax Information to Target Medicaid and CHIP Outreach. Idala’s presentation discussed the findings of Hilltop’s evaluation and reviewed data collection, outreach strategies, impact on enrollment, and lessons learned. The evaluation was funded by SHARE, a national program of the Robert Wood Johnson Foundation®, with direction by the State Health Access Data Assistance Center at the University of Minnesota School of Public Health.

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This report is the third in a series that explores the cross-payer effects of providing Medicaid long-term supports and services (LTSS) on Medicare acute care resource use. The report reflects an exploratory analysis of the relationships between Medicare resource use and Medicaid long-term supports and services to address the question: Does providing Medicaid LTSS influence dually eligible Medicaid recipients’ use of Medicare resources and, if so, how and to what extent? Report results suggest two general aspects of these effects: (1) Medicaid LTSS provided in the community are associated with an increase in the number of Medicare services used with no, or limited, additional Medicare costs overall, and (2) Medicaid institutional supports offset Medicare resource use overall. Analytic methods, including propensity score matching techniques used to conduct this analysis, are also highlighted in the report. Much like the first two reports, this report is intended to provide general background information on the interplay of Medicare and Medicaid resources using data from one state—Maryland—as an example for analysts who are beginning to examine similar issues at the state and federal levels.

Also in this series are: A Framework for State-Level Analysis of Duals: Interleaving Medicare and Medicaid Data, A Framework for State-Level Analysis of Duals: Interleaving Medicare and Medicaid Data–Poster Presentation, Examining Rate Setting for Medicaid Managed Long-Term Care, and Cross-Payer Effects on Medicare Resource Use: Lessons for Medicaid Administrators.

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This report, prepared for the Maryland legislature, discusses the progress of updating reimbursement rates for the Maryland Medical Assistance Program and the Maryland Children’s Health Program. Preparation of such a report is required annually by SB 481 of the 2002 legislative session.

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This Hilltop Issue Brief disseminates the findings of the first formal evaluation of the New Mexico State Coverage Insurance (SCI) program. The study objective was to identify factors that have influenced employer participation in SCI. The study findings highlighted in the brief draw from two employer surveys fielded in 2008 and site visits to interview program stakeholders conducted in July 2008 and May 2009. The evaluation was partially funded by the Robert Wood Johnson Foundation’s State Health Access Reform Evaluation (SHARE) program through a partnership between the New Mexico Human Services Department (HSD) and The Hilltop Institute.

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Hilltop continues to work remotely, so please reach us by email. You can find our team members’ email addresses by going to their bios located on the Teams page of our website.