This issue brief, published by the Commonwealth Fund, analyzes trends in paid and unpaid personal care and expenditures under a model Medicaid Community First Choice (CFC) program in Maryland. This brief highlights enrollment trends and costs per participant and concludes that a targeted benefit for Medicare beneficiaries could have a stable per-person cost and augment support from family and other unpaid caregivers, although take-up could increase over time to meet unmet need. Hilltop’s Cynthia Woodcock, Ian Stockwell, and Kaitlyn Whiton were contributing authors.

View PDF

The authors of this article, published by the Journal of Applied Gerontology, interviewed stakeholders in Maryland, one of the first states to adopt CFC, to assess challenges, benefits, and potential implications of this Medicaid option for state and federal policy makers. Study findings suggest that expanding coverage for home and community-based services (HCBS) through CFC in Maryland has been financially feasible, expanded the personal care workforce, and supported a more equitable approach to personal care services. The article concludes that greater coverage for HCBS is a promising avenue to improve access to care for high-need Medicaid beneficiaries. Hilltop’s Cynthia Woodcock and Ian Stockwell were contributing authors.

View PDF

Hilltop Senior Policy Analyst Charles Betley, MA, is a co-author of this top-cited article published in the journal Population Health Management. The article presents the findings of a study, funded by a grant from the Robert Wood Johnson Foundation, which sought to examine whether Supplemental Nutrition Assistance Program (SNAP) participation and benefit levels are associated with reduced subsequent hospital and emergency department utilization in low-income older adults who are eligible for both Medicare and Medicaid (dual eligibles). Researchers found that while participation in SNAP did reduce hospitalizations, it did not reduce ED visits. The research team is a collaboration led by Benefits Data Trust (BDT) including BDT, Hilltop, the Johns Hopkins Schools of Nursing and Public Health, and Northwestern University. Organizational partners include the Maryland Departments of Health and Human Resources.

View PDF

Hilltop Senior Policy Analyst Charles Betley, MA, is a co-author of this article published in the journal BMC Geriatrics. The article presents the findings of a study, funded by a grant from the Robert Wood Johnson Foundation, which sought to examine whether Supplemental Nutrition Assistance Program (SNAP) participation and benefit levels are associated with reduced subsequent hospital and emergency department utilization in low-income older adults who are eligible for both Medicare and Medicaid (dual eligibles). Researchers found that while participation in SNAP did reduce hospitalizations, it did not reduce ED visits. The research team is a collaboration led by Benefits Data Trust (BDT) including BDT, Hilltop, the Johns Hopkins Schools of Nursing and Public Health, and Northwestern University. Organizational partners include the Maryland Departments of Health and Human Resources.

View PDF

The Medicaid Long-Term Services and Supports in Maryland Chart Book, Volume 1, The Autism Waiver is the first in a series of three that explores service utilization and expenditures for Medicaid-funded long-term services and supports in Maryland. Volume 2 explores service utilization and expenditures for Maryland Medicaid’s Brain Injury Waiver. Volume 3 provides information on the state’s Medicaid Model Waiver.

View PDF

The Medicaid Long-Term Services and Supports in Maryland Chart Book, Volume 2, The Brain Injury Waiver is the second in a series of three that explores service utilization and expenditures for Medicaid-funded long-term services and supports in Maryland. Volume 1 explores service utilization and expenditures for Maryland Medicaid’s Autism Waiver. Volume 3 provides information on the states’ Medicaid Model Waiver.

View PDF

The Medicaid Long-Term Services and Supports in Maryland Chart Book, Volume 3, The Model Waiver is the third chart book in a series of three that explores service utilization and expenditures for Medicaid-funded long-term services and supports in Maryland. Volume 1 in this series explores service utilization and expenditures for Maryland’s Autism Waiver. Volume 2 provides this information for the Brain Injury Waiver.

View PDF

This chart book summarizes claims data for Medicaid beneficiaries in Mississippi using long-term services and supports (LTSS) data from calendar years (CYs) 2010 through 2014. It focuses on Mississippi’s five Medicaid waiver programs that provide home and community-based services (HCBS) to Medicaid-eligible individuals with low income and functional limitations. The waivers serve people who might otherwise require the services of a nursing facility, enabling them to return to or remain in the community.

View PDF

At the request of the Maryland Department of Health and Mental Hygiene (DHMH), The Hilltop Institute conducted a series of analyses on the health care utilization of Maryland’s full-benefit Medicare-Medicaid dual-eligible beneficiaries. Together, these analyses provide an overview of how this population accesses health care services, the types of services being used, and where the services are provided.

This analysis explores utilization of inpatient services by “high utilizer” full-benefit dual-eligible beneficiaries, defined as those who had three or more inpatient stays during CY 2012. The report examines demographics and county of residence; providers serving this population; chronic conditions and most frequent diagnosis-related groups; and Medicare and Medicaid expenditures and service days.

Related publications: Maryland Full-Benefit Dual-Eligible Beneficiaries’ Use of Medicare and Medicaid Services Preceding and Following a Medicare Inpatient Stay, An Analysis of Selected Mental Health Conditions among Maryland Full-Benefit Dual-Eligible Beneficiaries, and The Maryland Dual-Eligible Beneficiaries Chart Book.

View PDF

At the request of the Maryland Department of Health and Mental Hygiene (DHMH), The Hilltop Institute conducted a series of analyses on the health care utilization of Maryland’s full-benefit Medicare-Medicaid dual-eligible beneficiaries. Together, these analyses provide an overview of how this population accesses health care services, the types of services being used, and where the services are provided.

This report explores dual-eligible beneficiaries’ use of post-acute care (i.e., skilled nursing, inpatient rehabilitation, nursing facility services, hospice, and home health services) in the 30 days immediately following an inpatient stay, as well as their settings of care in the 7 days preceding an inpatient stay. In addition to pre- and post-inpatient settings, the report examines demographics, county of residence, and the most frequent diagnosis-related groups for the population studied.

Related publications: An Analysis of Selected Mental Health Conditions among Maryland Full-Benefit Dual-Eligible Beneficiaries, Characteristics of Maryland Full-Benefit Dual-Eligible Beneficiaries with Three or More Inpatient Stays, and The Maryland Dual-Eligible Beneficiaries Chart Book.

View PDF