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Change Healthcare Consulting partners with our clients to define a clear path forward in the complex maze of today’s healthcare environment. Ranked Best in KLAS for Payer IT Consulting Services, we are focused on enabling smarter business decisions to help you anticipate and navigate change. In support of this objective, we work side-by-side with our clients to define new strategies and bring them to life, unlocking the opportunities created by a shifting landscape.

Our services include strategic analysis and market intelligence; system assessment, selection and procurement; system implementation and upgrades; process optimization; program and project management; strategic staffing; and health plan start-up assistance. Our expertise covers service areas such as retail transformation; population health; government programs (e.g., Medicaid, Medicare); business transformation and optimization; and compliance.

We bring you specialists with decades of experience in hundreds of organizations and multiple markets. Real People. Real Experience. Real Results. Our team members average more than 20 years’ experience in the health industry before serving in a consulting role. We know what it means to optimize performance despite limited resources, organizational obstacles, and competitive pressures.

Change Healthcare’s Retention Services:

Our Medicaid Recertification Process is designed to reduce unnecessary churn, providing an average 18% lift in retention among those members that we support. Our program is designed using a customizable outreach schedule using digital, automated and live outreach; providing the following benefits:
• Application support and submittance to state
• Appeal management with our government services team
• Navigation to other coverage options if no longer eligible
• Data enrichment to provide updated member information

Value-Based Payment (VBP):

We work with many payers/providers to both initiate new value-based programs as well as scale existing APMs. We provide solutions for all LOBs. We find State Medicaid requirements are complex and difficult to administer. We customize our solutions to fit your programs unique goals and objectives. We are familiar with the CMS 1115 wavers and Medicaid state specific programs. We provide consultative services, analytic support, data insights, operational expertise, and targeted care management assistance.

Specifically:

• Efforts to design various alternative payment models (e.g., pay-for-performance, risk-sharing models, global payment/total cost of care models) – We leverage a large claims-based dataset to provide directional guidance on program design and structure. We also use our industry expertise to assess non quantitative, market specific concerns that are fundamental to consider when designing various models.
• Models that fall into various care system categories (e.g., maternity, behavioral health, pharmacy, social determinants of health) – For over a decade we have worked with both small regional plans and large national payers, creating and scaling various program categories (in addition to maternity, behavioral health, pharmacy, social determinants of health, sample programs are nephrology, chronic condition management, procedural or condition focused programs.)
• Efforts to support provider contracting; provider support activities (e.g., training, operations/workflow, data and analytic reporting) – We have worked with our payer customers to support provider contracting, information sharing, and training. Our support includes leveraging our analytics to identify of high and low performing providers as well as referral management insights (Provider level utilization patterns, cost and quality assessment.) to target specific training and support needs.
• Development of accountability measures – We work with our customers to augment and enhance their complication rate calculation, their HEDIS capture and their data transparency.
• General consultative services – Click for more information.

Contact:
David Gallegos
Senior Vice President, Consulting Services
3055 Lebanon Pike, Suite 1000
Nashville, TN  37214
C: 954-616-7862
dgallegos@changehealthcare.com
www.changehealthcare.com/consulting