Medicaid

From policy changes to IT services, our Medicaid consultants can guide you through it all.

Our large and growing team of Medicaid consultants includes former state Medicaid and CHIP directors and senior agency leaders, hospital and health plan executives, and senior officials from the Centers for Medicare & Medicaid Services (CMS) and public health systems. Their real-world experience and knowledge of the newest Medicaid innovations are an invaluable resource for our clients.

The expertise of HMA’s Medicaid team covers the full spectrum of services relevant to Medicaid and CHIP stakeholders, such as:

• Transformation of delivery systems and implementation of integrated models of care: Optimizing processes to enhance value and address health equity
• Establishment of Medicaid rates: Setting managed care organization rates and performing Medicaid risk adjustment for states
• Enhancement of eligibility, enrollment, and customer service systems: Improving IT systems and business functions across Medicaid, CHIP, and healthcare marketplaces
• Analysis of quality performance indicators: Assessing performance and developing quality improvements for plans, providers, and state programs
• Strategic planning and implementation of reform initiatives:  Leading the creation and execution of initiatives, including Section 1115 demonstration programs
• Evaluation of state and federal legislation: Assessing the efficacy of health policy and implementing policy changes
• Creation of community integration initiatives: Analyzing, designing, and implementing initiatives to ensure equity in healthcare access
• Assistance with state plan amendments and proposals: Writing the necessary documents for federal funding