This report describes the services The Hilltop Institute provided to the Maryland Department of Health (MDH) under the Master Agreement between Hilltop and MDH. The report covers fiscal year (FY) 2023 (July 1, 2022, through June 30, 2023). 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.
Pursuant to Maryland Health-General §15-103.5 and Insurance Article §19-807(d)(2), the Maryland Department of Health submits an annual report to the Governor and various House and Senate committees addressing the progress of the rate-setting process; a comparison of Maryland Medicaid’s reimbursement rates with those of other states; the schedule for adjusting Maryland’s reimbursement rates; and the estimated costs of implementing the above schedule and proposed changes to the fee-for-service reimbursement rates. This report, dated January 2024, satisfies these requirements for fiscal year 2023.
In 2014, the state of Maryland partnered with the Centers for Medicare and Medicaid Services (CMS) to modernize its unique all-payer rate-setting system for hospital services to improve the overall health of Maryland residents by increasing health care quality and reducing the cost of care. In service of providing better care at lower costs, The Hilltop Institute at UMBC, in partnership with the Maryland Department of Health, has developed predictive risk stratification models to identify patients at high risk for potentially preventable health care utilization that can be used to help target care resources to the patients who need them most.
This document strives to explain the intended use, technical implementation, and model performance of the Hilltop Pre- Models as of November 2022. The Pre- Models are a suite of prediction tools spanning the Pre-AH Model™, Pre-CH Model™, Pre-DC Model™, and Pre-HE Model™. This document will be updated as the models are updated or when new models become operational, and significant changes will be noted in the documentation edit history table and in the text when necessary. This first section of the codebook provides a short introduction; the second section provides a general overview of data sources, training methodology, and scoring methodology; the third section provides specific details on the performance and operations of each model within the Hilltop Pre- Models suite; and the fourth section presents limitations.
In this article published in the Gerontologist, Hilltop Director of Aging & Disability Studies Christin Diehl and Policy Analyst Roberto Millar, PhD—along with Nancy Kusmaul, PhD, and Ian Stockwell, PhD, from UMBC—discuss their study, which aimed to compare two quality frameworks: one based on observational factors and one based on family satisfaction.
Policy Analyst Parker James presented at the National Alliance of State & Territorial AIDS Directors (NASTAD) National HIV and Hepatitis Technical Assistance Meeting for the breakout session titled “Data Sharing between Surveillance and Medicaid Population Based Data Use.” His presentation focused on the successful collaboration between HIV Surveillance, Medicaid, and Hilltop in sharing HIV viral suppression data for quality measurement and improvement. This work is funded through the Health Resources and Service Administration’s Special Projects of National Significance Program, which supports the development of innovative models of HIV care and treatment.
In this article in the Health Affairs Forefront series, Hilltop Principal Data Scientist Morgan Henderson and Policy Analyst Morgane Mouslim posit that the reason there are no compliance studies is not because of lack of interest but because of the complexity of the landscape to which the regulation applies. Read the article online.
How well do US hospitals’ online prices posted for shoppable services correlate with their prices for the same service obtained via the telephone? In this cross-sectional study of 60 US hospitals, online and phone cash prices were poorly correlated within a given hospital for vaginal childbirth. These findings suggest that at US hospitals, price estimates for shoppable services posted online correlate poorly with prices obtained via phone; these findings suggest that patients will continue to face barriers to comparison shopping.
Assistance in Community Integration Services (ACIS) is a pilot program that is operated under Maryland’s §1115 demonstration waiver for HealthChoice, the state’s Medicaid managed care program launched in 1997. Under this pilot, the state provides a set of home and community-based services (HCBS) to a population that meets certain needs-based health and housing eligibility criteria. This summary report discusses ACIS program goals, eligibility criteria, services, and participating lead entities, followed by the study objectives, research methodology, key findings, and study limitations.
In this article in the Health Affairs Forefront series, Hilltop Policy Analyst Morgane Mouslim and Principal Data Scientist Morgan Henderson discuss whether novel and publicly available data generated from the Centers for Medicare and Medicaid Services’ new rule for transparency in coverage could be used to promote provider gender equity. Read the article online.
This report was prepared for the Maryland Department of Health as part of the second annual round of Hilltop Challenge awards. It highlights key concepts and findings in recent nursing facility quality of care literature and reviews two quality frameworks that inform nursing facility quality of care initiatives in Maryland. Below are highlights from three distinct studies.
