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

Takeaways from the ensuring access to Medicaid services final rule

This week’s second In Focus section delves into the Ensuring Access to Medicaid Services final rule. The Centers for Medicare & Medicaid Services (CMS) …

HMA opens registration for fall conference: Unlocking Solutions in Medicaid, Medicare, and Marketplace

Unlock Solutions in Medicaid, Medicare, and the Marketplace at HMA’s Fall Conference, October 7−9  This week, we preview what to expect …

New HMA report using VRDC data analyzes hip fracture outcomes in Dual Eligible population

In this new report, “Answering Questions Using Virtual Research Data Center (VRDC): How using Home and Community-Based Services (HCBS) Impacts …

The 2024 Presidential Election and its long-term impact on Medicaid

The prospect of new leadership due to a presidential election brings with it the potential for significant shifts in priorities, …

Medicare Physician Fee Schedule Reform: Structural Topics and Recommendations to Strengthen the System for the Future

Recent years have witnessed a growing bipartisan call to reform how Medicare reimburses for physician and other health professional services. …

Medicaid Unwinding Check-in: Data Informed Observations to Guide Future Action

In this week’s In Focus section, HMA Managing Director Matt Powers and Associate Principal Lora Saunders discuss observations and perspectives as we …

Five takeaways from the CMS Medicaid managed care final rule

This week, our In Focus section reviews significant Medicaid policy announcements from the Centers for Medicare & Medicaid Services (CMS). For example, …

Medicaid managed care enrollment update—Q4 2023

This week, our In Focus section reviews recent Medicaid enrollment trends in capitated, risk-based managed care in 30 states.1 Many state Medicaid agencies …

Medicaid managed care final rule: what to watch for

Our second In Focus section provides a refresher on the Medicaid and Children’s Health Insurance Program managed care access, finance, and quality proposed …

Medicaid managed care final rule anticipated soon

HMA has previously reviewed and discussed some of the implications of provisions put forward in the Medicaid and Children’s Health Insurance Program …

HMA 2024 Spring Workshop summary and key takeaways

On March 6, HMA convened a spring workshop of 100 healthcare stakeholders interested in making value-based care delivery and payment …

State teams convene to strengthen collaboration across child welfare, behavioral health, and Medicaid

This week, our In Focus section highlights the Children’s Behavioral Health (CBH) State Policy Lab, held February 7−9, in Baltimore, …

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

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