Medicaid managed care companies are increasingly facing new program requirements. Yesterday’s innovations are today’s table stakes. Our team brings strategic and innovative thinking about the next generation of innovative programs and provider/community-based organization contract strategies. As State Medicaid regulators are enhancing oversight of their managed care partners, our services help clients outperform on the expectations of state regulators for operational excellence and compliance.
Since our team includes experts who have been seated at both sides of the table, we offer clients well-rounded expertise on operational assessments and improvement opportunities to address state actions and to prepare for procurements. Our deep compliance expertise includes developing subcontractor delegation oversight programs and independent compliance program reviews; ensuring coding and payment accuracy; and providing support in disputes and investigations. We also provide financial health assessments through review of reporting and data science/analytics, actuarial/rate-setting and risk-adjustment adequacy review, and pro forma development.
As Medicaid procurements become increasingly competitive, FTI Consulting’s Medicaid team offers end-to-end support to incumbent and new-entrant Medicaid managed care organizations. Services include market entry strategy, operational capabilities assessments and remediation road maps, program development, pre- procurement strategy, win theme and strategic partnership development,, writing and mock-scoring services, readiness review support, post-procurement debriefing and analysis of scoring, and bid protest support.
1201 West Peachtree Street, Suite 500
Atlanta, GA 30309