Delivering Third-Party Liability Results, Mile After Mile

UMass Experts Talk About Where Medicaid Might Be Headed

How We Solve Medicaid Challenges

UMass Medical School helps states navigate their high-priority challenges, by offering specialized services and expertise to contain costs and improve outcomes. Our offerings address the following:

• An increased focus on developing new service delivery and financing models
• The importance of federal waivers in securing programmatic funding
• Long-term services and supports challenges for Medicaid enrollees with complex needs
• Supporting Medicaid as the Payer of Last Resort

Medicaid Consulting and Operations

Financing and claiming initiatives
Helping states recover significant costs and save millions

Policy design and development
Developing, evaluating, and implementing targeted health care policies

Drug management strategies for high-cost medications 
Curbing medication costs while improving treatment outcomes

Delivery System and Payment Reform

Federal approval for waivers
Navigating the waiver process from start to finish

Alternative payment systems
Helping develop shared savings arrangements, bundled payments, and global payments

Payment method modeling
​Evaluating how reimbursement and purchasing reforms affect financing and service delivery

Long-Term Services and Supports

Data analytics
Providing a complete picture of a complex population

Complex clinical case consultation
Ensuring Medicaid members receive the most appropriate and highest quality care

Disability determinations
​Providing medical and vocational reviews of disability cases

Medication therapy management
​Optimizing medication use and enhancing CMS star ratings

Medicare Eligibility Enhancement

Medicare and disability entitlement correction
Resolving federal errors to increase individual benefits and state savings

Medicare outreach and enrollment
Increasing Medicare enrollment for eligible Medicaid recipients

Medicare Premium Payment Review
​Integrating state and federal data to ensure accurate state Medicare buy-in expenditures