Principal Policy Analyst Dolapo Fakeye, PhD, presented this poster at the 2023 AcademyHealth Annual Research Meeting (ARM) held June 24-27, 2023, in Seattle.
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 20 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 (MDH) has requested and received seven §1115 waiver renewals.
The Hilltop Institute, on behalf of MDH, evaluates the program annually; this evaluation covers the period from CY 2017 through CY 2021.
Senior Policy Analyst Katherine Holmes, MPS, presented her research in this poster at the 2023 AcademyHealth Annual Research Meeting (ARM) held June 24-27, 2023, in Seattle.
Principal Policy Analyst Dolapo Fakeye, PhD, gave this podium presentation at the 2023 AcademyHealth Annual Research Meeting (ARM) held June 24-27, 2023, in Seattle.
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.