Medicaid Consulting at the State Level

For many health care providers, Medicaid is a major payer and an important regulator. Consequently, understanding state Medicaid policy – and how that policy might change in ways that could either benefit or hurt your organization – is essential.

DeBrunner & Associates help providers understand their state Medicaid program. We help them identify the Medicaid issues that are most important to them; track, define, analyze, and model new developments involving those issues; and evaluate how proposed changes in state Medicaid policies, reimbursement systems, and budgets would affect them.

All of these capabilities are vital today because state governments have never been more aggressive about pursuing enhanced federal funding to support their Medicaid programs. Providers need to understand, in dollars and cents, how possible changes in state Medicaid reimbursement systems – and even in delivery systems – might affect them. When your state proposes a new way of paying you for the services you provide to your Medicaid patients, DeBrunner & Associates can tell you how that new payment system will affect your Medicaid revenue.

This same desire to maximize federal Medicaid funding has made state Medicaid offices more receptive than ever to fresh ideas from providers. DeBrunner & Associates specializes in working with providers to craft new, creative approaches to helping their state governments enhance their federal Medicaid revenue and – equally important – distribute those new resources in ways that benefit your organization. In particular, we help providers urge their state governments to pursue federal revenue-generating Medicaid waivers – and then help those providers work to ensure that they maximize the financial benefits of those waivers.

To support these activities, DeBrunner & Associates analyzes and models state Medicaid budgets, plans, proposals, regulations, and reimbursement systems; calculates Medicaid hospital-specific upper payment limits; identifies and takes advantage of waivers, regulations, and other legitimate mechanisms for revenue enhancement; develops Medicaid reimbursement systems; and engages in numerous other innovative policy- and data-driven activities. Together, these capabilities enable our clients to maximize the financial benefits of their relationship with their state Medicaid program.