The Hilltop Pre- Models are risk prediction models developed by The Hilltop Institute at UMBC that use a variety of risk factors derived from Medicare claims data to estimate the event risk that a given patient incurs a given outcome in the near future. As of November 2022, there are three such prediction models in production for the Maryland Primary Care Program (MDPCP) population: the Hilltop Pre-AH Model™, which generates the “Avoidable Hospitalizations (PreAH)” scores; the Hilltop Pre-DC Model™, which generates the “Severe Diabetes Complications (Pre-DC)” scores; and the Hilltop Pre-HE Model™, which generates the “Hospice Eligibility and Advanced Care Planning (Pre-HE)” scores. These risk scores are displayed in the MDPCP Prediction Tools area on Chesapeake Regional Information System for our Patients (CRISP).
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.
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) 2022 (July 1, 2021, through June 30, 2022). 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.
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.
The Maryland Department of Health (MDH) engaged The Hilltop Institute and Aurrera Health Group to conduct a landscape needs assessment of the state’s School-Based Health Center (SBHC) Program. The assessment will inform the Program’s strategic priorities, growth, and structure as it transitions from the Maryland State Department of Education (MSDE) to MDH. The assessment includes an analysis of the status of SBHCs in Maryland, geographic areas that may benefit from establishing SBHCs, and recommendations for program implementation and SBHC funding allocation.
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.
This chart book, prepared for the Maryland Department of Health, compares the FY 2022 Medicaid reimbursement rates of Maryland and its surrounding states with Maryland’s Medicare fee schedule for CY 2021 for the Baltimore region. The surrounding states included in this study are Washington, DC; Delaware; Pennsylvania; Virginia; and West Virginia.
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 by calendar year (CY) 2018. Over 20 years after its launch, HealthChoice covered close to 90 percent of the state’s Medicaid and Maryland Children’s Health Program (MCHP) populations.
The Hilltop Institute, on behalf of the Maryland Department of Health (the Department), evaluates the program annually; this evaluation covers the period from CY 2016 through CY 2020.
Principal Data Scientist Morgan Henderson, PhD, presented his research in this poster at the 2022 AcademyHealth Annual Research Meeting (ARM) held June 4-7, 2022, in Washington DC. In addition, he served as an expert on a panel that discussed working in the field of health services research.