Government Programs Consulting

Expert consulting services for payers and providers that want to launch or expand Medicaid, Medicare, and Medicare Advantage lines of business.

Engage our Medicaid and Medicare Consulting Team

Select the right business lines and products to succeed in an evolving marketplace.

Engage our experts to write policies and procedures, and to handle training and implementation for special-needs plans, Medicare- and Medicaid-aligned incentives, and dual demonstrations.

Develop a provider network to support new care and payment models.

Achieve high CMS Star ratings and quality health outcomes.

Maintain regulatory compliance and prepare for audits.

Design and implement a rigorous special investigations unit to help identify, remedy, and prevent fraud, waste, and abuse.

Build Successful Government Healthcare Programs

Medicare and Medicare Advantage Consulting

Our team’s leadership, guidance, and support helped payers launch new Medicare lines of business that achieved 4+ Star ratings from CMS. We’ve supported Special Needs Plans, Dual Enrollment programs (D-SNP), start-ups, and more.

Our team supports:

  • Medicare Operations 
  • Compliance Program Effectiveness Audit
  • Program Audit Support and Remediation
  • Mock Program Audits
  • Delegation Oversight
  • MAPD and DSNP Markey Entry
  • Stars Program Improvement
  • Interim Staffing
  • CMS, MAPD, and DSNP Training
  • Model of Care
  • New Plan Application Support
  • Training
  • Customer Service

Medicaid Consulting

Our team has more than 30 years of experience helping payers launch and grow Medicaid plans.

Our team supports:

  • Staff training
  • Customer Service
  • Readiness Review Preparation
  • Interim Staffing 
  • Mock Program Audits

Medicare and Medicaid Provider Consulting

Our team assists with:

  • Provider Support
  • Revenue Cycle Management Operations
  • Value-Based Contracting

Talk to Sales 1-866-817-3813

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