Public Sector: Medicaid - CMA Consulting Services

Public Sector: Medicaid

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With an aging population and a growing number of people requiring complex healthcare services, the opening of State-Based Exchanges, and the Patient Protection and Affordable Care Act (ACA), Medicaid expenditures are expected to increase.

The goal is to manage the Medicaid budget while improving healthcare outcomes. A way to achieve this is through knowing your data well enough to identify opportunities. Data can help you uncover:

  • A speedier diagnosis process for patients, using proactive detection.
  • More easily prevented malpractice suits that arise from misdiagnosis.
  • Significantly reduced Medicaid costs.
  • A reduced number of preventable health visits.
  • Better managed high-risk patient cases.

CMA has extensive experience in the Medicaid realm. One of our flagship projects is the New York State Medicaid Data Warehouse.  We helped New York State create a comprehensive and secure health care information system environment, positioning NYS to meet the emerging needs of the next decade.

For example, New York’s Office of Medicaid Inspector General has now has recovered more than $1.73 billion in improperly expended Medicaid funds over the past three years.

CMA has also partnered with IBM on the Health Home Initiative to build the infrastructure needed to detect high-risk patients sooner, so they can be helped sooner. Being launched for the first time ever in NYS, this software empowers patients and healthcare providers to build a patient-care-centered culture.

Our team also has a detailed understanding of the Federal Medicaid regulations and experience required to implement automated Medicaid solutions to support programmatic and service requirements including:

  • Case Management
  • Program Integrity
  • Fraud and Abuse Prevention
  • Decision Support and Data Analytics