The Hilltop Institute

Presented at the 27th National Home and Community-Based Services (HCBS) Conference, this presentation discussed HCBS beginnings and momentum, including advocacy and costs, HCBS waivers, Aging and Disability Resource Centers (ADRCs), and Money Follows the Person (MFP), data and metrics to build community-based services, and using metrics to move forward.

This poster describes the use of a propensity score matching methodology to identify comparison groups among Medicare-Medicaid beneficiaries who received Medicaid-paid LTSS via HCBS waivers versus those who did not receive LTSS. This matching technique was used to establish comparable treatment/control pairs for subsequent analysis of cross-payer effects of providing Medicaid-paid LTSS on Medicare acute care resource use, and could be used more generally to strengthen policy analyses.

The purpose of this literature review is to better understand the various pathways to Medicare-Medicaid eligibility, how and why and individual becomes eligible for both programs. Also, this report presents examples of federal government- and state-sponsored programs and supports aimed at delaying or preventing a descent into functional decline and/or poverty. The ways to simplify the enrollment process for those who quality and need Medicare and Medicaid benefits are discussed as well.

This paper discusses the progress states have made in moving away from institutional care for Long-Term Supports and Services and toward home and community-based programs. It analyzes the opportunities available through the Affordable Care Act and other programs whereby states can continue that progress even in a challenging budget environment.

This study focuses on new Medicare-Medicaid enrollees in Maryland and the circumstances that shaped their initial eligibility for both programs. This report details the demographic and programmatic characteristics of new enrollees. Specifically, it serves as the vehicle for establishing an initial operational definition of new enrollees and developing the terminology needed to describe the circumstances surrounding initial Medicare-Medicaid eligibility.

This report describes and analyzes chronic disease patterns and health care expenditures of persons in Maryland who in 2008 began to receive coverage from both Medicare and Medicaid. The analysis focuses on disease and expenditure patterns in the year before these individuals, most of whom had been enrolled in Medicare alone or Medicaid alone, became enrollees in both programs. The results can provide a better understanding of simultaneous enrollment in Medicare and Medicaid.

This report evaluates the experience with the New Jersey Care Partner Support Pilot Program (Pilot) that was conducted in four counties in New Jersey in 2011. The Pilot aims at improving the knowledge and skills of family caregivers caring for adult family members and friends participating in New Jersey’s Medicaid Global Options home and community-based services waiver (GO Waiver) and the state-only funded Jersey Assistance to Community Caregivers (JACC) program.

Coordination of care activities and concepts include common cross-cutting themes. This report puts forth information regarding components of interventions that should be considered in the design, ongoing operation, and evaluation phases of most coordination of care efforts. It includes definitions, descriptions of funding programs, clinical programs, frameworks, and other state- and federal-level initiatives. The report pays particular attention to efforts germane to behavioral health disorders.

The Affordable Care Act of 2010 offers options & financial incentives for states seeking to expand systems of long-term services and supports. Many of these opportunities work together & build on existing initiatives, resulting in a strengthened infrastructure for service provision & an LTSS system that meets the needs of Medicaid beneficiaries. Key provisions of the ACA are summarized in this issue brief, followed by considerations for states seeking to take advantage of new opportunities.

This 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 for fiscal years 2006 through 2009. This Chart Book was prepared for the Maryland Department of Health and Mental Hygiene and is intended to monitor trends. Hilltop updates the chart book annually.