Medicaid

Our Medicaid consultants help you develop innovative strategies—and deliver better care.

HMA Medicaid consultants offer in-depth knowledge and experience to help states, plans, providers, and other stakeholders deliver the broad range of services demanded of Medicaid and Children’s Health Insurance Program (CHIP). Working with HMA, you can strengthen person-centered approaches to healthcare that connect with social services to promote equitable, high-quality care. And with our comprehensive grasp of state and federal policy landscapes, we can help you navigate policy and regulatory changes, and seize the opportunities they present.   

From policy changes to IT services, our Medicaid consultants can guide you through it all.

Our large and growing team of Medicaid consultants includes former state Medicaid and CHIP directors and senior agency leaders, hospital and health plan executives, and senior officials from the Centers for Medicare & Medicaid Services (CMS) and public health systems. Their real-world experience and knowledge of the newest Medicaid innovations are an invaluable resource for our clients.

The expertise of HMA’s Medicaid team covers the full spectrum of services relevant to Medicaid and CHIP stakeholders, such as:

  • Transformation of delivery systems and implementation of integrated models of care: Optimizing processes to enhance value and address health equity
  • Establishment of Medicaid rates: Setting managed care organization rates and performing Medicaid risk adjustment for states
  • Enhancement of eligibility, enrollment, and customer service systems: Improving IT systems and business functions across Medicaid, CHIP, and healthcare marketplaces
  • Analysis of quality performance indicators: Assessing performance and developing quality improvements for plans, providers, and state programs
  • Strategic planning and implementation of reform initiatives:  Leading the creation and execution of initiatives, including Section 1115 demonstration programs
  • Evaluation of state and federal legislation: Assessing the efficacy of health policy and implementing policy changes
  • Creation of community integration initiatives: Analyzing, designing, and implementing initiatives to ensure equity in healthcare access
  • Assistance with state plan amendments and proposals: Writing the necessary documents for federal funding

Medicaid insights

Federal policymakers consider current and future spending measures on simultaneous tracks

This week, our In Focus section covers Congress’s and the Administration’s parallel efforts to finalize fiscal year (FY) 2024 spending bills and …

Medicaid Managed Care Spending in 2023

This week, our In Focus section analyzes preliminary 2023 Medicaid spending data collected in the annual CMS-64 Medicaid expenditure report. After submitting …

North Carolina releases foster care specialty plan program RFP

This week, our In Focus section reviews the statewide North Carolina request for proposals (RFP) for the new Children and Families Specialty …

Driving change in healthcare delivery: HMA Spring Workshop builds towards policy and strategy frameworks necessary to implement value-based care

Federal policy frameworks establishing alternative payment models in Medicare and Medicaid have been the kick-starter of value-based care (VBC) innovation …

Interoperability and patient access final rule: the next phase in the data exchange journey

This week, our In Focus section reviews the Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule, published on …

Pennsylvania releases community HealthChoices (CHC) Medicaid managed care RFA

This In Focus section reviews the request for applications (RFA) that the Commonwealth of Pennsylvania Department of Human Services (DHS) released January 30, …

CMS approves next phase of New York’s Medicaid 1115 waiver journey

This week, our In Focus section describes New York State’s Medicaid Section 1115 waiver amendment authorizing at least $6.7 billion in funding …

Webinar replay – Navigating change: exploring the opportunities of New York’s 1115 Medicaid waiver amendment

This webinar was held on January 24, 2024. During this webinar, HMA panel guides you through the key provisions of …

Rhode Island releases Medicaid managed care program RFP

This week our In Focus section reviews the Rhode Island statewide, capitated risk-bearing Medicaid managed care program request for proposals (RFP), which …

Medicaid Business Transformation DC: recommendations for technical assistance

HMA was engaged by the Washington, District of Columbia Department of Health Care Finance (DHCF) to lead their Medicaid Business …

CMS Transforming Maternal Health Model offers state Medicaid agencies an opportunity to accelerate improvements in quality and outcomes

This week, our In Focus section reviews the new Transforming Maternal Health (TMaH) Model, which the Centers for Medicare & Medicaid Services (CMS) …

Medicaid Business Transformation DC: Recommendations for Technical Assistance

HMA was engaged by the Washington, District of Columbia Department of Health Care Finance (DHCF) to lead their Medicaid Business …

Ready to talk to a Medicaid/CHIP expert about your project?

Schedule a Consultation

Schedule a consultation