Medicaid Performance Management

Solution Center
  • PDF
  • Print

Reduce medical expense by more than $6.00 PMPM to successfully navigate the challenges of growth and health reform

Core Drivers of Value
  • $1.65 to $3.40 PMPM through data-driven recontracting
  • $0.80 to $1.85 PMPM via reduced inappropriate utilization
  • $0.40 to $0.65 PMPM from improved formulary management
  • $0.85 to $1.75 PMPM by better managing Aged, Blind and Disabled (ABD) population

Solution Overview
Medicaid Performance Management enables Medicaid plans to solve the medical and provider network management challenges they face in providing access to care for vulnerable populations. By addressing the specific needs of low-income families and the care of high-volume, multi-comorbid, chronically ill beneficiaries, clients who have implemented MedeAnalytics’ solution for Medicaid managed care have experienced significant savings.

MedeAnalytics aggregates claims, encounter, mental health, membership, provider demographics and other data to provide plan staff with a centralized, robust view of care delivery, costs and quality. Combining these disparate data sources and generating sophisticated, composite performance measures allows Medicaid plans to ensure effective, efficient, high-quality care at the lowest price for their members.

Able to be implemented within 90 days, Medicaid Performance Management features a web-based performance management platform and is supported by experienced healthcare professionals to ensure rapid and sustainable results. MedeAnalytics delivers performance management solutions across the healthcare system—including hospitals, physician practices and payers—to ensure accountability and improve financial, operational and clinical outcomes.

img
Examples of key performance indicators
(click to enlarge)
Learn more about Medicaid Performance Management
Click to download the data sheet

"MedeAnalytics helps us identify emerging trends and issues impacting our membership and network providers. The solutions support the Alliance in managing member care and provide us with the ability to adapt and change in the future as our membership grows."

- Ingrid Lamirault

Chief Executive Officer

Alameda Alliance for Health