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.
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.
This chart book explores service utilization and expenditures for dual-eligible beneficiaries (individuals who are eligible to receive both Medicare and Medicaid services)—with a focus on full-benefit dual-eligible beneficiaries—of all ages who received services in calendar years (CY) 2018 through CY 2022.
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 is the fourth annual review of the integration requirements for Medicare Advantage dual eligible special needs plans (D-SNPs) completed for the Maryland Department of Health. The goal of D-SNP integration, which became effective in calendar year (CY) 2021, is to help improve coordination of care transitions for individuals who are dually eligible for Medicare and Medicaid. This review covers key findings from the fourth year of implementation.
Director of Analytics and Research Morgan Henderson, Executive Director Alice Middleton, and Director of Health Reform Studies Laura Spicer gave this presentation at the American Economic Association Annual Conference. This work examined why Medicaid work requirements had high compliance in Arkansas but very low compliance in Georgia.
Hilltop Policy Analyst Morgane Mouslim, DVM, and Director of Analytics and Research Morgan Henderson, PhD, as well as Associate Professor Simone Singh of the University of Michigan, are co-authors of this article published in the American Journal of Managed Care. The authors present the results of their study that analyzes changes in emergency department (ED) facility fees for self-pay patients and highlights growing affordability challenges for uninsured and underinsured individuals. Drawing on hospital price transparency data from 926 hospitals reporting self-pay ED facility fees in both 2021 and 2023, the study identified significant inflation-adjusted price increases across all visit severity levels, with the steepest growth observed at for-profit and system-affiliated hospitals and in communities with higher proportions of uninsured Hispanic/Latino residents.
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.
This chart book explores utilization and expenditures for Medicaid-funded LTSS in Maryland for state fiscal year (FY) 2019 through FY 2023. The focus of this chart book is on Medicaid nursing facility services, with one chapter that illustrates Maryland’s efforts at providing home and community-based services (HCBS) to an increasing number of Medicaid recipients who may otherwise be served in nursing facilities.