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

CMS invites states to apply for transforming maternal health model

This week, our In Focus section reviews the notice of funding opportunity (NOFO) for the Transforming Maternal Health (TMaH) Model, which the Centers …

Unlocking Solutions in the Medicaid, Medicare, and Marketplace Programs

HMA is hosting its 2024 Fall Conference October 7−9 in Chicago, IL. Unlocking Solutions in Medicaid, Medicare, and Marketplace Programs promises to …

The Health Equity & Access for Rural Dually Eligible Individuals Toolkit: Raising Rural Voices

A public health crisis is growing more acute in rural America, disproportionately impacting individuals with both Medicaid and Medicare (the …

An HMA toolkit and webinar to advance health equity & access for rural dually eligible individuals

In 2022, HMA convened stakeholder roundtables in three states – including New Mexico, North Dakota, and Tennessee to identify the …

Advancing health equity and integrated care for rural dual eligibles

This week, our In Focus section highlights the Health Affairs article, Advancing Health Equity and Integrated Care for Rural Dual …

Webinar replay: rural health equity for dually eligible individuals: improving access to services and integrated care programs

This webinar was held on February 2, 2023.  Dually eligible individuals covered under Medicare and Medicaid living in rural areas …

HMA report evaluates needs of Nevada’s Medical Assistance for the Aged, Blind, and Disabled program

The Nevada Division of Health Care Financing and Policy (DHCFP) engaged HMA to evaluate Nevada’s Medical Assistance for the Aged, …

Webinar replay: supporting family caregivers: the changing policy and practice landscape

This webinar was held on June 27, 2024. Over the past decade, the U.S. has seen significant federal and state …

Ohio releases next generation MyCare Ohio program RFA

This week’s In Focus section delves into the Next Generation MyCare Ohio managed care program, spotlighting the request for applications (RFA) that …

Summary of the CMS managed care final rule and its impact on states, managed care organizations and providers

Looking ahead The provisions of the final rule range in their effective dates from as early as the final rule’s …

Federal healthcare quality initiatives: recent developments reshaping the landscape

This week, our In Focus section considers the increasing emphasis on quality at all levels of our healthcare system, especially for work …

Election-driven shifts in healthcare innovation 

Innovation is the source of progress, driving advancements across industries and shaping the way we live, work, and interact. However, …

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