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Model your agreements to improve managed Medicaid health plan payments

When it comes to containing Medicaid costs, states face tough choices. Many have been forced to freeze or reduce provider payments, impose prescription drug restrictions, or mandate enrollment in managed Medicaid health plans (MMHP). To improve the flow of capitated dollars from managed Medicaid contracts, provider organizations must build a better business case to prepare for health plan negotiations, execute those strategies at the bargaining table, and integrate those agreements with end-to-end revenue cycle operations, according to Christopher J. Kalkhof, MHA, FACHE, director of life sciences and healthcare in the Cleveland office of Deloitte Consulting, LLP, and Paul Goebel, MBA, CHE, senior vice president and executive director of Saint Vincent Catholic Medical Centers of New York in New York City.