An Analysis of Medicaid Costs for Persons with Traumatic Brain Injury While Residing in Maryland Nursing Facilities

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The Maryland Department of Health and Mental Hygiene (DHMH), on behalf of Maryland’s Money Follows the Person (MFP) demonstration, requested that The Hilltop Institute conduct a study to provide a better understanding of service utilization by Medicaid beneficiaries with traumatic brain injury (TBI) who reside in nursing facilities. This study examined nursing facility service utilization and costs for individuals with a diagnosis of TBI, anoxia, or both TBI and anoxia. Hilltop concluded that for Maryland’s MFP demonstration to succeed in its goal of transitioning persons with brain injury from institutional settings to the community, it will be important to ensure that appropriate community-based mental health services, occupational/physical/speech therapies, and durable medical equipment are available to this population. In addition, because psychotropic medication utilization is significant among this population, medication use must be carefully managed and monitored.