This is the first annual review of the integration requirements for Medicare Advantage dual eligible special needs plans (D-SNPs), completed for the Maryland Department of Health. The goal of D-SNP integration, which became effective in calendar year (CY) 2021, is to improve coordination of care transitions for individuals who are dually eligible for Medicare and Medicaid. To meet this goal, D-SNPs are required to notify the state designees (e.g., supports planners) of Medicare hospital and skilled nursing facility (SNF) admissions when members receive long-term services and supports (LTSS) through a home and community-based services (HCBS) waiver or state plan program. This review describes key findings from the first year of implementation, focusing on aggregate trends.
This chart book explores utilization and expenditures for Medicaid-funded long-term services and supports (LTSS) in Maryland for state fiscal year (FY) 2016 through FY 2020. 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.
Using Medicaid data (2017 to 2018) from four states participating in a distributed research network, this retrospective cohort study documents the prevalence of specific types of co-occurring substance use disorder (SUD) among Medicaid enrollees with an opioid use disorder (OUD) diagnosis.
Senior Policy Analyst Shamis Mohamoud and Policy Analyst Rosa Perez were part of the Medicaid Outcomes Distributed Research Network (MODRN) team of authors of this article published in the Journal of Substance Abuse Treatment.
Policy Analyst Advanced Roberto Millar, PhD, Senior Programmer Erick Geil, and Director of Aging & Disability Studies Christin Diehl co-authored this article published in the Journal of Applied Gerontology.
In Maryland, residential service agencies deliver Medicaid home and community-based services (HCBS) to older adults with disabilities through direct care workers. Leveraging survey data from residential service agency administrators, this study describes agency characteristics and participant and family caregiver experiences by participant dementia status. Findings lay the foundation for future longitudinal and embedded interventions within Medicaid HCBS.
The Community Supports Waiver provides community-based services and supports to individuals of all ages with developmental or intellectual disabilities. This infographic presents information for fiscal years (FYs) 2019 and 2020.
The Family Supports Waiver provides community-based services and supports to individuals aged 21 years or younger with developmental or intellectual disabilities. This infographic presents information for fiscal years (FYs) 2019 and 2020.
Autism Waiver services enable individuals who have autism spectrum disorder and who meet an institutional level of care to be supported in their own homes or community-based settings. Due to the high demand for Autism Waiver services and a defined capacity, individuals wishing to receive waiver services must have their name placed on the Autism Waiver Registry. This infographic presents data about the list and its registrants for FY 2018 to FY 2022.
Follow-up after residential treatment is considered best practice in supporting patients with opioid use disorder (OUD) in their recovery. Yet, little is known about rates of follow-up after discharge. The objective of this analysis was to measure rates of follow-up and use of medications for OUD (MOUD) after residential treatment among Medicaid enrollees in 10 states, and to understand the enrollee and episode characteristics that are associated with both outcomes.
Senior Policy Analyst Shamis Mohamoud was part of the Medicaid Outcomes Distributed Research Network (MODRN) team of authors of this article published in Drug and Alcohol Dependence.
The Hilltop Pre-DC Model™—which generates the rankings for the Severe Diabetes Complications (Pre-DC) scores—is designed to facilitate the active management of type 2 diabetes by estimating individuals’ risk of incurring inpatient admissions or emergency department (ED) visits for severe diabetes complications. The Pre-DC 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 proactively identify high-risk individuals and allocate scarce care management resources.
In the US, Medicaid covers over 80 million Americans. Comparing access, quality, and costs across Medicaid programs can provide policymakers with much-needed information. As each Medicaid agency collects its member data, multiple barriers prevent sharing Medicaid data between states. To address this gap, the Medicaid Outcomes Distributed Research Network (MODRN) developed a research network of states to conduct rapid multi-state analyses without sharing individual-level data across states.
Senior Policy Analyst Shamis Mohamoud and Director of Medicaid Policy Studies David Idala were part of the Medicaid Outcomes Distributed Research Network (MODRN) team of authors of this article published in Medical Care.