Hilltop staff made several presentations at the 2017 AcademyHealth Annual Research Meeting (ARM) in New Orleans. At the State Health Research and Policy Interest Group Meeting on June 24, Policy Analyst Jamie John, MPH, presented this poster, which provides a picture of diabetes-related service use and costs in HealthChoice, Maryland’s Medicaid managed care program, in calendar years 2013 and 2014.

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Hilltop staff made several presentations at the 2017 AcademyHealth Annual Research Meeting (ARM) in New Orleans. At the State Health Research and Policy Interest Group Meeting on June 24, Senior Policy Analyst Charles Betley, MA, presented this poster. Because Maryland is among the 13 states that only cover emergency dental benefits for adults, this research sought to estimate the cost to Maryland to expand Medicaid dental coverage for adults in order to cover a broader range of services.

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This report presents the findings of an assessment of the impact of diabetes on Maryland’s Medicaid program. The assessment focuses on adults aged 35 to 64 years enrolled in HealthChoice, Maryland’s Medicaid managed care program. The Hilltop Institute at the University of Maryland, Baltimore County (UMBC) conducted this assessment for MedChi, the Maryland State Medical Society, to provide a detailed view of the effects of diabetes diagnoses on the use of health care services and expenditures among adult HealthChoice enrollees.

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HealthChoice—Maryland’s statewide mandatory Medicaid managed care program—was implemented in 1997 under authority of Section 1115 of the Social Security Act. Since the inception of HealthChoice, the Maryland Department of Health has conducted five comprehensive evaluations of the program as part of the 1115 waiver renewals. Between waiver renewals, the Department completes an annual evaluation for HealthChoice stakeholders. This report is the 2014 annual evaluation of the HealthChoice program.

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On March 29, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a final rule on Medicaid and Children’s Health Insurance Programs; Mental Health Parity and Addiction Equity Act of 2008; the Application of Mental Health Parity Requirements to Coverage Offered by Medicaid Managed Care Organizations (MCOs), the Children’s Health Insurance Program (CHIP), and Alternative Benefit Plans (ABPs) (https://www.gpo.gov/fdsys/pkg/FR-2016-03-30/pdf/2016-06876.pdf). This rule provides new requirements for Medicaid and CHIP compliance with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equality Act of 2008 (MHPAEA) and the Affordable Care Act (ACA). Final MHPAEA regulations for group health insurance plans were issued in 2013. Much of this final rule extends the MHPAEA requirements for group health plans to Medicaid MCOs, CHIP, and ABPs, with exceptions and changes as applicable to address the unique aspects of state Medicaid mental health (MH) and substance use disorder (SUD) delivery systems. This document provides a high-level summary of the rule and highlights the changes to the proposed rule.

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At the request of the Maryland Department of Health and Mental Hygiene (DHMH), The Hilltop Institute conducted a series of analyses on the health care utilization of Maryland’s full-benefit Medicare-Medicaid dual-eligible beneficiaries. Together, these analyses provide an overview of how this population accesses health care services, the types of services being used, and where the services are provided.

This analysis explores utilization of inpatient services by “high utilizer” full-benefit dual-eligible beneficiaries, defined as those who had three or more inpatient stays during CY 2012. The report examines demographics and county of residence; providers serving this population; chronic conditions and most frequent diagnosis-related groups; and Medicare and Medicaid expenditures and service days.

Related publications: Maryland Full-Benefit Dual-Eligible Beneficiaries’ Use of Medicare and Medicaid Services Preceding and Following a Medicare Inpatient Stay, An Analysis of Selected Mental Health Conditions among Maryland Full-Benefit Dual-Eligible Beneficiaries, and The Maryland Dual-Eligible Beneficiaries Chart Book.

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At the request of the Maryland Department of Health and Mental Hygiene (DHMH), The Hilltop Institute conducted a series of analyses on the health care utilization of Maryland’s full-benefit Medicare-Medicaid dual-eligible beneficiaries. Together, these analyses provide an overview of how this population accesses health care services, the types of services being used, and where the services are provided.

This report examines full-benefit dual-eligible beneficiaries with mental health conditions in Maryland during calendar year (CY) 2012, including number and type of mental health conditions; demographics and county of residence; emergency department use; and Medicare and Medicaid expenditures and service days.

Related publications: Maryland Full-Benefit Dual-Eligible Beneficiaries’ Use of Medicare and Medicaid Services Preceding and Following a Medicare Inpatient Stay, Characteristics of Maryland Full-Benefit Dual-Eligible Beneficiaries with Three or More Inpatient Stays, and The Maryland Dual-Eligible Beneficiaries Chart Book.

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At the request of the Maryland Department of Health and Mental Hygiene (DHMH), The Hilltop Institute conducted a series of analyses on the health care utilization of Maryland’s full-benefit Medicare-Medicaid dual-eligible beneficiaries. Together, these analyses provide an overview of how this population accesses health care services, the types of services being used, and where the services are provided.

This report explores dual-eligible beneficiaries’ use of post-acute care (i.e., skilled nursing, inpatient rehabilitation, nursing facility services, hospice, and home health services) in the 30 days immediately following an inpatient stay, as well as their settings of care in the 7 days preceding an inpatient stay. In addition to pre- and post-inpatient settings, the report examines demographics, county of residence, and the most frequent diagnosis-related groups for the population studied.

Related publications: An Analysis of Selected Mental Health Conditions among Maryland Full-Benefit Dual-Eligible Beneficiaries, Characteristics of Maryland Full-Benefit Dual-Eligible Beneficiaries with Three or More Inpatient Stays, and The Maryland Dual-Eligible Beneficiaries Chart Book.

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The Maryland Dual-Eligible Beneficiaries Chart Book provides an overview of Maryland dual-eligible beneficiaries with breakdowns by benefit category, age, race, gender, and county of residence; the cost to Medicare and Medicaid of providing care to this population; and the prevalence and costs of chronic health conditions. The chart book is the most recent edition in Hilltop’s chart book series, which includes publications on Medicaid long-term services and supports in Maryland and Medicaid services for individuals with traumatic brain injury and autism.

Related publications: Maryland Full-Benefit Dual-Eligible Beneficiaries’ Use of Medicare and Medicaid Services Preceding and Following a Medicare Inpatient Stay, An Analysis of Selected Mental Health Conditions among Maryland Full-Benefit Dual-Eligible Beneficiaries, and Characteristics of Maryland Full-Benefit Dual-Eligible Beneficiaries with Three or More Inpatient Stays.

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Hilltop provided this report to the Maryland Dental Action Coalition (MDAC) to examine the cost and policy implications of expanding adult dental coverage under Maryland Medicaid. Currently, Maryland is among 15 states that only cover emergency dental benefits for adults, while 17 states provide limited but broader coverage, and 15 states provide extensive coverage, according to the Center for Health Care Strategies. The only exceptions to this coverage limitation in Maryland are dental services for pregnant women and individuals enrolled in the Rare and Expensive Case Management program.

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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.