The Hilltop Pre-AH Model™—which generates the rankings for the Avoidable Hospitalizations (Pre-AH) scores—is designed to assist providers by allowing them to easily identify patients at a high risk of incurring an avoidable inpatient hospitalization or emergency department (ED) visit. The Pre-AH Model provides risk scores and reasons for risk for all attributed beneficiaries of Maryland Primary Care Program (MDPCP) practices every month to help care teams make informed decisions about how to direct scarce care coordination resources to the individuals who will benefit from them the most.
This annual report, written for the UMBC community, provides an overview of key projects and staff accomplishments for FY 2024.
The Maryland Primary Care Program (MDPCP) began in January 2019 as a key element of the state’s Total Cost of Care (TCOC) Model, an agreement between CMS and the state of Maryland. MDPCP is a voluntary program that provides funding and support for the delivery of advanced primary care throughout the state. It allows primary care providers to play an increased role in the prevention and management of chronic disease, as well as in the prevention of unnecessary hospital utilization, with the ultimate goal of improving quality of care while reducing Medicare TCOC growth.
This report documents the causal impact of the introduction of MDPCP on utilization and expenditure and is the state’s commissioned evaluation of the program to fulfill the 2024 Joint Chairmen’s Report (JCR) requirement of an independent evaluation of MDPCP.
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) 2018 through CY 2022.
Policy Analyst Advanced Morgane Mouslim, ScM, DVM, presented this poster at the 2024 AcademyHealth Annual Research Meeting (ARM) held June 29 – July 2 in Baltimore.
On April 10, 2024, Hilltop Deputy Director Alice Middleton was one of three speakers at a session of the University of Baltimore-sponsored Rosenberg Dialogue Series, titled Fixing Unintended Pandemic Medicaid Policy Consequences: Lessons Learned and Insurance Coverage Implications for Recipients. In the session, speakers discussed the national context and state variations in qualifying disenrolled persons for coverage, Maryland Medicaid experiences with this policy complication for continuous enrollment, and generating data and information for evidence-based decisions.
As Mississippi is actively considering expanding its Medicaid program, Hilltop created this informational brief to capture key facts regarding Medicaid policy options as they apply to a potential Medicaid expansion in Mississippi.
As Mississippi is actively considering expanding its Medicaid program, Hilltop created this informational brief to capture key facts regarding Medicaid work requirements as they apply to a potential Medicaid expansion in Mississippi.
Medicaid enrollments typically reflect programmatic factors (such as eligibility thresholds or outreach efforts) and underlying economic factors (such as recessions). As Mississippi is actively considering expanding its Medicaid program, The Hilltop Institute assembled publicly available Medicaid enrollment trend data from another state (Louisiana) to show its expansion enrollment over time.
Hilltop Principal Data Scientist Morgan Henderson, PhD, and Executive Director Cynthia Woodcock, MBA, presented Hilltop research to the Mississippi House Medicaid Committee. The research – a 2021 economic analysis of Medicaid expansion in Mississippi – was commissioned by the Center for Mississippi Health Policy, a nonprofit, non-partisan organization.