Data Scientist Leigh Goetschius, PhD, presented her research in this poster at the 2023 AcademyHealth Annual Research Meeting (ARM) held June 24-27, 2023, in Seattle. Executive Director Cynthia Woodcock presented this poster.
This chart book explores utilization and expenditures for Medicaid-funded LTSS in Maryland for state fiscal years (FYs) 2017 through 2021. 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.
The Hilltop Pre- Models are risk prediction models developed by The Hilltop Institute at UMBC that use a variety of risk factors derived from Medicare claims data to estimate the event risk that a given patient incurs a given outcome in the near future. As of November 2022, there are three such prediction models in production for the Maryland Primary Care Program (MDPCP) population: the Hilltop Pre-AH Model™, which generates the “Avoidable Hospitalizations (PreAH)” scores; the Hilltop Pre-DC Model™, which generates the “Severe Diabetes Complications (Pre-DC)” scores; and the Hilltop Pre-HE Model™, which generates the “Hospice Eligibility and Advanced Care Planning (Pre-HE)” scores. These risk scores are displayed in the MDPCP Prediction Tools area on Chesapeake Regional Information System for our Patients (CRISP).
The Hilltop Pre-HE Model™—which generates the rankings for the Hospice Eligibility and Advanced Care Planning (Pre-HE) scores—is designed to support proactive advanced care planning discussions by estimating a patient’s risk of eligibility for hospice. The Pre-HE Model provides risk scores and reasons for risk for all attributed beneficiaries of Maryland Primary Care Program (MDPCP) practices every month in order to identify patients that are potentially appropriate for hospice care and to provide care teams with information that can guide the sensitive and difficult conversations about end-of-life care with patients and their families.
This report describes the services The Hilltop Institute provided to the Maryland Department of Health (the Department) under the Master Agreement between Hilltop and the Department. The report covers fiscal year (FY) 2022 (July 1, 2021, through June 30, 2022). 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.
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.
The Assistance in Community Integration Services (ACIS) pilot program began in late 2017 with the goal of reducing unnecessary health services use among Medicaid beneficiaries by providing tenancy and housing case management services through four lead entities (LEs). This infographic provides a brief overview of Hilltop’s 2021 review of the pilot program.
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 (CYs) 2015 through 2019.
The Maryland Department of Health (MDH) engaged The Hilltop Institute and Aurrera Health Group to conduct a landscape needs assessment of the state’s School-Based Health Center (SBHC) Program. The assessment will inform the Program’s strategic priorities, growth, and structure as it transitions from the Maryland State Department of Education (MSDE) to MDH. The assessment includes an analysis of the status of SBHCs in Maryland, geographic areas that may benefit from establishing SBHCs, and recommendations for program implementation and SBHC funding allocation.
Reducing hospital readmissions is a federal policy priority, and predictive models of hospital readmissions have proliferated in recent years; however, most such models tend to focus on the 30-day readmission time horizon and do not consider readmission over shorter (or longer) windows. The objective of this study, co-authored by Drs. Morgan Henderson and Fei Han and published in the Journal of General Internal Medicine, was to evaluate the performance of a predictive model of hospital readmissions over three different readmission timeframes in a commercially insured population.