Government Programs Consulting

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


Engageour Medicaid and Medicare Consulting Team

  • Select the right business lines and products to succeed in an evolving marketplace.
  • Develop a provider network to support new care and payment models.
  • Maintain regulatory compliance and prepare for audits.
  • 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.
  • Achieve high CMS Star ratings and quality health outcomes.
  • 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

Our outcomes

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