On behalf of the Partnership for a Healthier Carroll County, Inc., The Hilltop Institute (as the Center for Health Program Development and Management) conducted an assessment of community strengths and needs for Carroll County, Maryland. The assessment consisted of a review of secondary data sources, key stakeholder interviews, and a comprehensive survey of households in the county. This report focuses on survey findings from households with children under age eighteen.

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In this report, Ian Axford Fellow John O’Brien, former director of acute care policy at The Hilltop Institute (as the Center for Health Program Development and Management), compares performance measurement in the New Zealand health care delivery system with performance measurement in HealthChoice, Maryland’s Medicaid managed care program. As illustrated by these two health care delivery systems, performance measurement is likely to be an evolving set of metrics that can be applied for a variety of purposes. Indeed, performance measurement offers a window into the biases and thought processes of policymakers and offers important lessons for health care delivery.

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In response to recent dramatic increases in Medicaid spending, the Michigan legislature mandated a study evaluating the cost-effectiveness of capitated managed care involving multiple managed care organizations compared to three alternative delivery systems: fee-for-service, primary care case management, and a capitated managed care program involving a single statewide managed care organization. The Hilltop Institute (as the Center for Health Program Development and Management) was retained by the Michigan Department of Community Health to conduct this study.

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Home- and community-based services waiver programs enable many individuals who are dually eligible for Medicare and Medicaid to avoid nursing homes. However, there was concern at the time that access to prescription drugs may be impeded with the transer of drug coverage from Medicaid to Medicare in January 2006, threatening the ability of dual eligibles to remain in the community. This issue brief examines the likely impact of the new Medicare drug benefit in Maryland and recommended federal policy remedies.

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The Early and Periodic Screening and Diagnostic Testing (EPSDT) Program provides age-specific standards for preventive and primary care services for Medicaid-eligible children. To monitor compliance with program requirements, the state of Maryland commissions a team of nurses to conduct annual record reviews of a sample of certified providers. The Hilltop Institute (as the Center for Health Program Development and Management) carried out an inter-rater reliability evaluation to assess the consistency of nurses’ ratings.

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On behalf of the Partnership for a Healthier Carroll County, Inc., The Hilltop Institute (as the Center for Health Program Development and Management) conducted an assessment of community strengths and needs for Carroll County, Maryland. The assessment consisted of a review of secondary data sources, key stakeholder interviews, and a comprehensive survey of households in the county. This report focuses on findings from key stakeholders.

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As Medicaid managed care programs mature, states are looking to refine their methods for measuring and improving the performance of participating health plans. This report serves as a guide for Medicaid agencies who want to develop a performance measurement program using administrative data to evaluate the care provided to enrollees with chronic diseases. The report identifies potential performance indicators that are associated with improved medical outcomes and demonstrates the application of diagnosis-based risk adjustment to performance measurement by profiling six health plans.

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This presentation summarizes the methodology for the community strengths and needs assessment that The Hilltop Institute (as the Center for Health Program Development and Management) conducted for Carroll County, Maryland. Survey findings related to the health, education, and well-being of the county’s children are presented in a series of charts and graphs.

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A major challenge to expanding home- and community-based services (HCBS) alternatives to institutional long-term care is finding funding sources to pay for HCBS. Unless states can develop policy interventions that actually reduce expenditures in institutional settings, any expansion in HCBS requires new state funds. This issue brief presents several approaches states can use to reduce nursing facility utilization and expenditures in order to make funds available to expand HCBS.

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In planning for long-term care, adults take into consideration both the place of care and the persons to provide care. In this study, 1,500 adults aged 40-70 were surveyed about future long-term care needs and their preferences for care setting and caregivers.

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