T2C Medicaid Framework
Coordinated Care/Managed Care Strategy
- Align leadership and partners on goals, implementation strategies, operational infrastructure; organizational roles, and care delivery models
- Design infrastructure, governance and oversight for hospitals, counties and sub-regions
- Integrate behavioral healthcare and Population Health Management into care delivery systems
IT Technology Development
- Collaborate with multiple vendors across the healthcare spectrum (i.e., population health, analytics, and/or revenue cycle)
- Select new platforms and/or optimize current platforms to support organizational strategy, system integration and workflow integration
- Identify platforms for sales/quoting, enrollment, billing, product definition, provider contracting, claims processing, encounter submissions, care management and customer service
Outcomes and Reporting Analytics
- Implement analytical and business intelligence tools, measurement review and monitoring practices to enable ongoing process improvements and demonstrate improved outcomes and achievement of measures to qualify for payments.
- Ensure a smooth launch for reporting capabilities related to new regulatory claims and encounter reporting for Medicaid line of business
- Enhance and mature claims testing processes
- Improve accuracy and forecasting of capitation payment reconciliation
- Reduce costs and increase claims accuracy
Contracting and Financial Management
- Develop bidding strategies
- Manage capitation payment audits
- Assess provider contracting and enhance claims processing infrastructure
Community Engagement and Communication
- Coordinate and track community engagement and communication programs utilizing large-scale and complex project management expertise
- Define strategies to transform relationships with the provider communities and enhance the quality of care delivered to members
- Establish buy-in and alignment across stakeholders for new platforms, vendors and implementation plans
T2C has helped clients successfully address these important issues. Our senior level practitioners have domain knowledge of Medicaid and can help you develop the right solutions to meet your needs.
ARE YOU MANAGING COSTS WHILE OPTIMIZING QUALITY?
We can help. Partner with T2C today.