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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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 2013 annual evaluation of the HealthChoice program.

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The Medicaid Long-Term Services and Supports in Maryland Chart Book, Volume 2, The Autism Waiver is the second chart book in a series of two that explores service utilization and expenditures for Medicaid-funded long-term services and supports in Maryland. Volume 1 in this series explores service utilization and expenditures for Maryland Medicaid’s Living at Home Waiver, Waiver for Adults, and Medical Day Care Waiver, as well as Maryland State Plan personal care services and Medicaid nursing facility utilization and expenditures.

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Network adequacy refers to a health plan’s ability to provide reasonable access to sufficient in-network providers. Essential community providers (ECPs) serve low-income and medically underserved populations and include such providers as federally qualified health centers (FQHCs), Ryan White designated providers, family planning clinics, Indian health providers, and specified hospitals. Pursuant to federal regulations, the Maryland Health Benefit Exchange (MHBE) is interested in further developing policies for ECPs and provider network adequacy. To achieve this goal, the MHBE tasked its Standing Advisory Committee (SAC) to create a Network Adequacy and ECP Workgroup (Workgroup), charged with reviewing background materials and developing and assessing various policy options for provider network standards. The Workgroup included 16 members, representing carriers, providers, and consumer advocacy organizations.

 

This report summarizes the background materials Hilltop developed for the Workgroup and the Workgroup’s discussions of policy options. The purpose of this report is to provide input to the MHBE Board of Trustees for the 2017 benefit year.

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This chart book summarizes demographic and Medicaid service and expenditure data for Marylanders using LTSS in state fiscal years (FYs) 2010 through 2013. Medicaid programs and services addressed in this chart book include the Living at Home (LAH) Waiver, the Medical Day Care Services (MDC) Waiver, the Waiver for Older Adults (WOA), Medical Assistance Personal Care (MAPC) Program, Medicaid Nursing Facility Services, and Money Follows the Person.

 

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Hilltop staff made several presentations at the 2015 AcademyHealth Annual Research Meeting (ARM) held June 13 through June 15 in Minneapolis. Senior Policy Analyst Shamis Mohamoud, MA, presented this poster at an ARM poster session on June 15.

The objective of the analysis presented in the poster is to explore the prevalence of potentially preventable hospitalizations among adult Medicaid enrollees in Maryland, and the characteristics associated with increased likelihood of a potentially preventable hospitalization.

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Health Homes are intended to improve health outcomes for individuals with chronic conditions by providing patients with an enhanced level of care management and care coordination. The goal of this report is to provide a description of Medicaid enrollees’ participation in the Maryland Health Home program and their interactions with the health care system during the first year of program implementation.

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During the 2013 Legislative Session, the Maryland General Assembly passed House Bill 228 (Chapter 159, Acts of 2013), entitled the Maryland Health Progress Act of 2013. Section 6 of Chapter 159 requires the Maryland Health Benefit Exchange (MHBE) and the Maryland Insurance Administration (MIA) to conduct a joint study of the impact of the Affordable Care Act’s allowance of a tobacco use rating of 1.5 to 1, including (1) its effect on insurance premiums generally; (2) its effect on the affordability and purchase of insurance, and access to health care, for tobacco users; and (3) any disparate impact on specific vulnerable populations. The study must further assess the options that may be available to the state to address any adverse consequences of tobacco use rating.

 

Hilltop worked with the MHBE and the MIA to conduct this legislatively mandated study. This report contains the findings of the study and concludes with options for further legislative action.

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This is the first chart book in a series of two that explores service utilization and expenditures for Medicaid-funded long-term services and supports in Maryland. This volume explores service utilization and expenditures for Maryland Medicaid’s Living at Home Waiver, Older Adults Waiver, and Medical Day Care Waiver, as well as Maryland State Plan personal care services and Medicaid nursing facility utilization and expenditures in state fiscal years (FYs) 2009 through 2012. Hilltop updates the chart books annually.

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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.