This chart book is the third in a series that explores service utilization and expenditures for Medicaid-funded long-term services and supports in Maryland. It provides information about Maryland Medicaid participants who received services through the Medical Day Care Waiver in fiscal years 2012 through 2016. The 1915(c) Medical Day Care Waiver provides medical day care services to persons aged 16 and over who are eligible for Medicaid and who meet a nursing facility level of care.
This chart book is the fourth in a series that explores service utilization and expenditures for Medicaid-funded long-term services and supports in Maryland. It summarizes demographic, service utilization, and expenditure data for Model Waiver participants for fiscal years 2012 through 2016. The Model Waiver allows individuals with medically complex needs and a chronic hospital or nursing facility level of care to received needed services in their homes.
This chart book is the fifth in a series that explores service utilization and expenditures for Medicaid-funded long-term services and supports in Maryland. The focus of this chart book is on Medicaid HCBS, with one chapter dedicated to illustrating Maryland’s efforts at providing these services to an increasing number of Medicaid recipients who may otherwise be served in institutions.
This chart book is the sixth in a series that explores utilization and expenditures for Medicaid‐funded LTSS in Maryland for fiscal years (FYs) 2012 through 2016. 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.
Pursuant to SB 481 (Chapter 464 of the Acts of 2002), the Maryland Department of Health (the Department) created an annual process to set the fee-for-service (FFS) reimbursement rates for Maryland Medicaid and the Maryland Children’s Health Program (MCHP) in a manner that ensures provider participation. The law directs the Department to submit 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 FFS reimbursement rates. This is the Department’s annual report dated June 2019.
Hilltop staff presented at the 2019 AcademyHealth Annual Research Meeting (ARM). On June 3, Senior Director of Analytics and Research and Chief Data Scientist Ian Stockwell, PhD, presented this poster, which summarizes the work he led to identify factors found in clinical and functional assessment tools that increase the risk of a future nursing home (NH) admission and apply those risk-scoring coefficients to individuals on Maryland’s Home and Community-Based Services (HCBS) waiting list.
Hilltop staff presented at the 2019 AcademyHealth Annual Research Meeting (ARM). Senior Policy Analyst Charles Betley, MA, presented this poster at both the State Health Policy Interest Group Meeting on June 1 and the ARM on June 3. This poster summarizes the work Betley led to analyze Mississippi Medicaid claims data and quantify the financial impact of tobacco use on Mississippi’s Medicaid program.
Hilltop staff presented at the 2019 AcademyHealth Annual Research Meeting (ARM). Director of Health Reform Studies Laura Spicer, MA, and Senior Policy Analyst Alexis Smirnow, MPH, gave this podium presentation about the potential of implementing Small Business Health Options Program (SHOP) in Maryland at the State Health Policy Interest Group Meeting on June 1.
As part of its participation in the Maryland Primary Care Program (MDPCP), The Hilltop Institute is developing a risk model that will score primary care patients attributed to MDPCP-participating practices according to risk of avoidable hospitalization and/or emergency department (ED) utilization. These patient-level risk scores will ultimately be vended to participating medical practices on a monthly basis in order to facilitate care management through the improved allocation of scarce care coordination resources.
As a first step in this process, Hilltop conducted a comprehensive literature review. The goal of the review was to find peer-reviewed academic journal articles that identify risk factors for potentially avoidable hospitalization, thus providing a basis for risk factor extraction and risk model feature creation. Identified risk factors will be coded using CCLF and other publicly available data sources and included in the final risk model as potential predictors of avoidable hospitalization or ED use. The literature review provides the foundation for the MDPCP risk model and is a crucial step in the modeling process.
This report is an update to the 2016 Health Home Evaluation Report and the 2015 Joint Chairmen’s Report on Patient Outcomes for Participants in Health Homes. Its purpose is to describe the outcomes of participants in the Maryland Health Home program. Maryland’s Health Home program targets Medicaid participants with a serious and persistent mental illness (SPMI) and/or an opioid substance use disorder (SUD) and risk of additional chronic conditions due to tobacco, alcohol, or other non-opioid substance use; as well as children with serious emotional disturbances (SED).
