This report is the third in a series that explores the cross-payer effects of providing Medicaid long-term supports and services (LTSS) on Medicare acute care resource use. The report reflects an exploratory analysis of the relationships between Medicare resource use and Medicaid long-term supports and services to address the question: Does providing Medicaid LTSS influence dually eligible Medicaid recipients’ use of Medicare resources and, if so, how and to what extent? Report results suggest two general aspects of these effects: (1) Medicaid LTSS provided in the community are associated with an increase in the number of Medicare services used with no, or limited, additional Medicare costs overall, and (2) Medicaid institutional supports offset Medicare resource use overall. Analytic methods, including propensity score matching techniques used to conduct this analysis, are also highlighted in the report. Much like the first two reports, this report is intended to provide general background information on the interplay of Medicare and Medicaid resources using data from one state—Maryland—as an example for analysts who are beginning to examine similar issues at the state and federal levels.
Also in this series are: A Framework for State-Level Analysis of Duals: Interleaving Medicare and Medicaid Data, A Framework for State-Level Analysis of Duals: Interleaving Medicare and Medicaid Data–Poster Presentation, Examining Rate Setting for Medicaid Managed Long-Term Care, and Cross-Payer Effects on Medicare Resource Use: Lessons for Medicaid Administrators.
This report, prepared for the Maryland legislature, discusses the progress of updating reimbursement rates for the Maryland Medical Assistance Program and the Maryland Children’s Health Program. Preparation of such a report is required annually by SB 481 of the 2002 legislative session.
This Hilltop Issue Brief disseminates the findings of the first formal evaluation of the New Mexico State Coverage Insurance (SCI) program. The study objective was to identify factors that have influenced employer participation in SCI. The study findings highlighted in the brief draw from two employer surveys fielded in 2008 and site visits to interview program stakeholders conducted in July 2008 and May 2009. The evaluation was partially funded by the Robert Wood Johnson Foundation’s State Health Access Reform Evaluation (SHARE) program through a partnership between the New Mexico Human Services Department (HSD) and The Hilltop Institute.
This series of chart books, entitled Medicaid Long-Term Supports and Services in Maryland, summarizes demographic, service utilization, and expenditure data for state fiscal years 2001 through 2008 on three Maryland Medicaid waiver programs—the Older Adults Waiver, the Living at Home Waiver, and the Autism Waiver—and on nursing facility utilization among Maryland Medicaid recipients. These chart books, prepared for the Maryland Department of Health and Mental Hygiene, are intended to monitor trends in these programs. Hilltop plans to update the chart books annually.
The Older Adults Waiver Chart Book provides information on Maryland Medicaid participants who receive services through this program, which enables low-income individuals aged 50 years and older to remain in a community setting even though, because of their health status, they are eligible for placement in a long-term care facility. The Older Adults Waiver is administered by the Maryland Department of Aging.
Also in this series are: The Living at Home Waiver Chart Book, The Autism Waiver Chart Book, and The Nursing Facilities Chart Book.
This series of chart books, entitled Medicaid Long-Term Supports and Services in Maryland, summarizes demographic, service utilization, and expenditure data for state fiscal years 2001 through 2008 on three Maryland Medicaid waiver programs—the Older Adults Waiver, the Living at Home Waiver, and the Autism Waiver—and on nursing facility utilization among Maryland Medicaid recipients. These chart books, prepared for the Maryland Department of Health and Mental Hygiene, are intended to monitor trends in these programs. Hilltop plans to update the chart books annually.
The Living at Home Waiver Chart Book provides information on Maryland Medicaid participants who receive services through this program, which provides community-based services and supports for low-income individuals with physical disabilities who are aged 18 to 64 years at the time of enrollment, and who would otherwise require the services of a nursing facility. The Living at Home Waiver is administered by Maryland Medicaid.
Also in this series are: The Older Adults Waiver Chart Book, The Autism Waiver Chart Book, and The Nursing Facilities Chart Book.
This series of chart books, entitled Medicaid Long-Term Supports and Services in Maryland, summarizes demographic, service utilization, and expenditure data for state fiscal years 2001 through 2008 on three Maryland Medicaid waiver programs—the Older Adults Waiver, the Living at Home Waiver, and the Autism Waiver—and on nursing facility utilization among Maryland Medicaid recipients. These chart books, prepared for the Maryland Department of Health and Mental Hygiene, are intended to monitor trends in these programs. Hilltop plans to update the chart books annually.
The Autism Waiver Chart Book provides information on Maryland Medicaid participants who receive services through this program, which provides home and community-based services to children aged 1 through 21 years with Autism Spectrum Disorder. The Autism Waiver is administered by the Maryland State Department of Education.
Also in this series are: The Older Adults Waiver Chart Book, The Living at Home Waiver Chart Book, and The Nursing Facilities Chart Book.
This series of chart books, entitled Medicaid Long-Term Supports and Services in Maryland, summarizes demographic, service utilization, and expenditure data for state fiscal years 2001 through 2008 on three Maryland Medicaid waiver programs—the Older Adults Waiver, the Living at Home Waiver, and the Autism Waiver—and on nursing facility utilization among Maryland Medicaid recipients. These chart books, prepared for the Maryland Department of Health and Mental Hygiene, are intended to monitor trends in these programs. Hilltop plans to update the chart books annually.
The Nursing Facilities Chart Book reports on nursing facility services provided to Maryland Medicaid beneficiaries aged 19 years and older. It summarizes demographic, service utilization, acuity, expenditure, and length of stay data.
Also in this series are: The Older Adults Waiver Chart Book, The Living at Home Waiver Chart Book, and The Autism Waiver Chart Book.
Hilltop’s Director of Special Research and Development, Tony Tucker, gave this presentation to the Maryland Department of Health and Mental Hygiene (DHMH) Long-Term Care Payment Advisory Committee (LTC PAC). It describes RUGs, the LTC minimum data set (MDS) as it is used to assign RUGs to nursing facility (NF) residents, and Hilltop’s process to refine MDS data to examine patterns of care. Hilltop refined MDS data were also used to show the distribution of Maryland’s NF residents, as well as measures of length of NF stays, by RUG level and payor.
This presentation, delivered by Charles Milligan to the Maryland Department of Health and Mental Hygiene (DHMH) Long-Term Care Payment Advisory Committee (LTC PAC), describes findings from a Hilltop study that examined the Medicaid nursing facility (NF) payment systems of all 50 states and the District of Columbia. It also compares Maryland’s payment system to that in other states.
The Maryland Kids First Act was signed into law in May 2008. It directed the Maryland Department of Health and Mental Hygiene (DHMH) to use the state’s personal income tax system to target outreach efforts to children who might be eligible for Medicaid or CHIP (in Maryland, known as the Maryland Children’s Health Program, or MCHP). To study whether this outreach strategy is effective, the State Health Access Reform Evaluation (SHARE) Program, a national program of the Robert Wood Johnson Foundation, commissioned DHMH and its partner, The Hilltop Institute, to evaluate the outreach effort. Hilltop researchers performed the study on behalf of DHMH. The brief highlights the findings and identifies 10 lessons learned from the experience so far, addressing issues such as data-sharing, health literacy, inclusion/exclusion criteria, tracking mechanisms, and the circumstances under which legislation is necessary in order to implement tax-based outreach.