As of the writing of this review, Mississippi was 1 of 12 states to have not expanded its Medicaid program under the Affordable Care Act (ACA). Recent discussion on a possible expansion within the state, however, has demonstrated the need for timely, non-partisan research on this topic. To that end, the Center for Mississippi Health Policy contracted with The Hilltop Institute to conduct a study of the economic impact of a (hypothetical) Medicaid expansion, with a focus on Mississippi’s Medicaid program, state budget, and provider landscape. As part of the development of the analytic plan for the study, Hilltop conducted this literature review in order to document relevant findings that can help inform the study design.
Healthcare programs such as Medicaid provide crucial services to vulnerable populations but, due to limited resources, many of the individuals who need these services the most languish on waiting lists. Survival models can potentially improve this situation by predicting individuals’ levels of need, which can then be used to prioritize the waiting lists. Providing care to those in need can prevent institutionalization for those individuals, which both improves quality of life and reduces overall costs. While the benefits of such an approach are clear, care must be taken to ensure that the prioritization process is fair, and does not reinforce harmful systemic bias. In this study, we develop multiple fairness definitions and corresponding fair learning algorithms for survival models to ensure equitable allocation of healthcare resources. We demonstrate the utility of our methods in terms of fairness and predictive accuracy on three publicly available survival data sets.
Senior Director of Research and Analytics/Chief Data Scientist Ian Stockwell, PhD co-authored this article published in proceedings of the 2021 Society for Industrial and Applied Mathematics (SIAM) International Conference on Data Mining.
Pursuant to Maryland Health-General §15-103.5 and Insurance Article §19-807(d)(2), the Maryland Department of Health (MDH) submits 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 fee-for-service reimbursement rates. This report, dated January 2021, satisfies these requirements for fiscal year 2020.
As directed by the 2020 Joint Chairmen’s Report from the Maryland General Assembly, Hilltop, in consultation with the Maryland Department of Health, examined Maryland’s Home and Community-Based Options Waiver (CO Waiver), established in 2014 through a merger of the Waiver for Older Adults and the Living at Home Waiver. To address the Joint Chairmen’s request, Hilltop conducted this five-part study.
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) 2020 (July 1, 2019, through June 30, 2020). 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.
View this timeline to see the process Hilltop followed to develop and implement the Hilltop Pre-AH Model.
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 by calendar year (CY) 2018. Over 20 years after its launch, HealthChoice covered close to 90 percent of the state’s Medicaid and Maryland Children’s Health Program (MCHP) populations.
The Hilltop Institute, on behalf of the Maryland Department of Health (the Department), evaluates the program annually; this evaluation covers the period from CY 2014 through CY 2018.
This provides a brief look at the Hilltop Pre-AH Model™, a risk prediction model that uses a variety of risk factors derived from Medicare claims data to estimate the probability that a given patient incurs an avoidable hospital event in the near future. These risk scores are intended to assist Maryland Primary Care Program (MDPCP) practices with the identification of beneficiaries that have a high risk of incurring an avoidable hospitalization or emergency department event. The Pre-AH Model™ risk scores, used in conjunction with provider clinical guidance, can facilitate a more efficient and impactful allocation of practices’ care management resources.
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) 2019 (July 1, 2018, through June 30, 2019). 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.
In 1997, HealthChoice—Maryland’s statewide mandatory Medicaid and Children’s Health Insurance Program managed care program—became operational as a waiver of standard federal Medicaid rules, under authority of §1115 of the Social Security Act. The Centers for Medicare & Medicaid Services approved subsequent waiver renewals in 2005, 2007, 2010, 2013, and 2016. The Maryland Department of Health continually monitors HealthChoice performance on a variety of measures across the demonstration’s goals, culminating in an annual evaluation. This report—the 2019 annual evaluation—includes data from calendar year (CY) 2013 through CY 2017.