This is the first chart book in a series that explores utilization and expenditures for Medicaid-funded LTSS in Maryland for state fiscal year (FY) 2014 through FY 2018. 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.

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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.

Read the article online.

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.

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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.

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View this timeline to see the process Hilltop followed to develop and implement the Hilltop Pre-AH Model.

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This chart book, prepared for the Maryland Department of Health, compares the FY 2020 Medicaid reimbursement rates of Maryland and its surrounding states with Maryland’s Medicare fee schedule for CY 2019 for the Baltimore region. The surrounding states included in this study are Washington, DC; Delaware; Pennsylvania; Virginia; and West Virginia. Physician fees comprise three components: physician’s work, practice expense, and malpractice insurance expense.

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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.

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This chart book—from a series that explores service utilization and expenditures for Medicaid-funded long-term services and supports in Maryland—summarizes data for Autism Waiver participants for fiscal year (FY) 2013 through FY 2017.

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This chart book is the second in a series that explores utilization and expenditures for Medicaid-funded long-term services and supports (LTSS) in Maryland for state fiscal years (FYs) 2014 through 2018. The focus of this chart book is on Medicaid HCBS, with one chapter dedicated to illustrating Maryland’s efforts at providing these services to an increasing number of Medicaid recipients who may otherwise be served in institutions. Medicaid programs and services addressed in this chart book include the following: the Home and Community-Based Options (CO) Waiver, Community First Choice (CFC), Community Personal Assistance Services (CPAS), Medical Day Care Services (MDC) Waiver, Money Follows the Person (MFP), and Medicaid nursing facility services.

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