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
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.
Predictive analytics identify opportunities for intervention and prevention.
Share insights with plan staff and providers to organize, prioritize, and target care to reduce both risk and cost.
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