UMBC established The Hilltop Institute in 1994 as the Center for Health Program Development and Management in a unique partnership with the Maryland Department of Health (the Department). Hilltop (as the Center) was initially chartered to design and manage a health care services program for Marylanders who were both financially indigent and had multiple, complex health care needs. The program later became the Rare and Expensive Case Management (REM) program. Today, the Department operates REM and Hilltop supports the program by conducting data analysis for program monitoring.
Hilltop was instrumental in the 1997 launch of HealthChoice, Maryland’s Medicaid managed care program. Hilltop developed the Section 1115 waiver application to the federal government and, when the waiver was granted, assumed responsibility for calculating capitated payment rates for health plans participating in HealthChoice. Hilltop has continued to carry out rate setting and actuarial responsibilities for HealthChoice, which currently enrolls 1.1 million Marylanders with capitated payments of almost $6 billion annually. Hilltop also develops payment methodologies and rates for PACE (Program of All-Inclusive Care for the Elderly) and other long-term services and supports (LTSS) programs.
To carry out its rate setting responsibilities, Hilltop needed ready access to Maryland Medicaid claims and encounter data. Hilltop began building a secure data repository in the late 1990s. Today, Hilltop maintains not only Medicaid data, but also Maryland hospital discharge data, Medicare data, nursing home assessment data, data on commercially insured individuals, and interRAI assessments for Medicaid LTSS participants. Hilltop has developed expertise in linking data sets at the individual level to provide a more comprehensive view of an individual’s experience in the health care system. Hilltop has used its linked data set on Marylanders enrolled in both Medicare and Medicaid (“dual-eligible beneficiaries”) to perform in-depth analyses of this population. Hilltop has also conducted analyses for other states using Medicaid administrative data. Hilltop’s analysts and SAS programmers are highly skilled in data-driven analysis to inform federal and state policymaking.
Today, Hilltop is one of the largest research centers on the UMBC campus. Hilltop continues to maintain a nationally recognized partnership with the Department to analyze state health policies and develop solutions for the Maryland Medicaid program. Over the years, Hilltop’s work has grown to include data analytics, research, and policy analysis for other state agencies, including the Maryland Health Benefit Exchange, the Maryland Health Care Commission, the Maryland Health Services Cost Review Commission, the Maryland Community Health Resources Commission, and the Maryland Department of Health’s Divisions of Behavioral Health and Disabilities and Public Health Services. Hilltop also works with local government and health and human services agencies.
Hilltop engages in projects with other states, the federal government, and foundations. Hilltop provided consultation to state Medicaid agencies in New Mexico, New Jersey, Rhode Island, and Mississippi on transforming LTSS financing and delivery systems. Over the years, Hilltop has partnered with faculty members from UMBC and other universities to conduct research for the Centers for Medicare & Medicaid Services, the National Institutes of Health, the Department of Housing and Urban Development, and other federal agencies. Hilltop has received research funding from the Robert Wood Johnson Foundation, the Pew Charitable Trusts, the Commonwealth Fund, the Annie E. Casey Foundation, and the John A. Hartford Foundation to conduct policy analysis and evaluate new programs. Hilltop’s Hospital Community Benefit Program—launched in 2011 with grants from the Robert Wood Johnson Foundation and the Kresge Foundation—continues to be an important resource for state and local policymakers.
Now in its 24th year, Hilltop is a founding member of AcademyHealth’s State-University Partnership Learning Network (SUPLN) and offers technical assistance to the growing network of partnerships involving public universities and their state Medicaid agencies. Hilltop is also participating in SUPLN efforts to expand cross-state research collaborations.