Health care today is more complex than ever. Whether it’s understanding the ramifications of health care reform, developing care strategies for special populations, synthesizing research into effective policy, or adapting to new fiscal realities, organizations of every shape and size are struggling to make sense of the changes sweeping through the system — all while containing costs and providing the highest level of care.
Our team helps clients make sense of financing issues that touch all aspects of health care, particularly in public programs. Every state spends a substantial portion of its state budget providing health care services, especially for at-risk and vulnerable residents. We understand these health care system challenges — because we’re a part of it.
We have financing expertise and services that cover policy implications, third-party liability, insurance reform, Medicaid and Medicare savings initiatives, revenue recovery, federal claiming, program integrity, benefit coordination, and more. Examples of our work and accomplishments include:
- Helped states develop new payment methods and modeling how proposed reforms would affect system financing and service delivery.
- Generated more than $50 billion in savings and revenue for the Commonwealth of Massachusetts during the 17-year partnership with MassHealth and EOHHS.
- Corrected a systematic flaw in the Social Security Administration’s eligibility system that resulted in more than $250 million being refunded to states nationwide.
- Helped state and local governments secure more than $1 billion in federal reimbursement through our school-based Medicaid claiming initiatives.
- Generated more than $5 million in annual revenue for cities and towns in Massachusetts by appropriately billing for vaccine administration services.