Medicaid Management

Ensure quality, cost-effective care for Medicaid beneficiaries.

Medicaid plans face unique challenges serving beneficiaries. The only Medicaid-specific solution on the market, Medicaid Management helps Medicaid plans to address the needs of vulnerable populations, improve care for high-volume, multi-comorbid, chronically ill beneficiaries, and extend those lessons to the Exchange market.

  • Leverage our deep, national Medicaid expertise

  • Find opportunities for healthcare savings

  • Provide cost-effective, quality care to ABDs and Duals

  • Meet state-specific performance requirements

  • Get a handle on specialty drug impacts

  • Evaluate program effectiveness

  • Aggregation

    Medical and pharmacy claims, membership, authorization, and care management data provide a comprehensive view of everything from strategic economic issues to specific care management opportunities.

  • Interpretation

    Predictive analytics identify opportunities for intervention and prevention.

  • Transformation

    Share insights with plan staff and providers to organize, prioritize, and target care to reduce both risk and cost.

Track quality concerns specific to Medicaid

Track quality concerns specific to Medicaid

Monitor policy impact on disparities and access to care

Monitor policy impact on disparities and access to care

Track key performance metrics to identify opportunities for cost savings

Track key performance metrics to identify opportunities for cost savings

Identify variations and monitor utilization by service type

Identify variations and monitor utilization by service type

What It Offers

  • Medicaid-specific analyses
  • Healthcare economics
  • Identification and stratification
  • Medical policy guidance
  • Network sufficiency
  • Analyses for moms and babies, duals, ABDs, and Exchange members
Questions? Talk to one of our experts. Contact us