You are here

Transforming Medicaid Service Delivery

Printable versionSend by emailPDF version

Medicaid is the largest health insurance program in the United States, accounting for over one-quarter of total state spending with this fiscal commitment growing. Therefore, states are struggling to meet their financial and programmatic requirements because of increased service demand, the expansion authorized under the Affordable Care Act and regulatory reforms.

We provide high-impact results while laying the foundation — financially, operationally and organizationally — for sustainable success long after our engagement ends.

Improving financial transparency.
Serving as interim CFOs and budget directors, we prepare detailed budget models that identify key financial drivers, achieve transparency and provide reporting tools to assist in understanding trends.

Making rate changes stick.
We help you understand the fiscal and political impacts of rate decisions, including changing rate methodologies, to ensure you can sustain rate changes.

Keeping pace with the evolving regulatory environment.
We work with states’ internal and external stakeholders to change their processes and waivers to comply with federal regulations. We also draft and review state-specific fiscal and programmatic regulations. 

Using IT to optimize Medicaid operations.
Through business process reengineering, we define a path for state Medicaid organizations to transform programmatic and fiscal operations and payment systems. After assessing information technology solutions, we implement systems that automate and transform the state’s administration of home and community-based waiver services.

Building an effective Medicaid organization.
We assess the existing organization, build a new organizational chart with defined roles and responsibilities, and help states recruit and train key staff. We ensure your entire organization is focused on accountability, communication and coordination.