Policy

FCG specializes in developing innovative payor and provider partnerships and programs that build on the unique strengths of our clients

Areas of policy focus include:

• Advanced payment models and shared incentives
• Design of Medicaid ACO programs
• Programs and payment models for Medicare-Medicaid dual eligible populations
• Development of policies and programs for state-based exchanges
• Leveraging opportunities for federal funding in program design
• Facilitating community/stakeholder involvement in program design

Recent projects have included:

• Medicaid Funding Models: Developed innovative funding model, leveraging DSHP authority structure and university expenditures, to support payment model innovations for a state Medicaid agency
• Medicaid ACO programs: Designed and facilitated the implementation of a Medicaid ACO program for a state Medicaid agency. Within this program, developed alternative payment models that create appropriate financial incentives and rewards for payors and providers
• Dual Eligibles: Designed and implemented programs and payment models for Medicare-Medicaid dual eligible populations
• 1332 Waivers: Designed and developed a 1332 waiver program for a state-based exchange, establishing both a reinsurance program and a state-based health insurance mandate
• HCBS Payment Models: Designed and developed payment model enhancements for home and community-based providers
• COVID related payment innovations: Developed and implemented innovative payment models and support programs for LTSS providers struggling with COVID related challenges
• Hospital Care Transitions Program: Designed, developed and implemented a multipayor Hospital Care Transitions Program, targeting populations at risk for post-acute long term care services
• Social Determinants of Health: Supported the design and development of a Medicaid ACO’s Flexible Services Program for housing-related social needs and a nutrition program, including stakeholder engagement, developing budget and return-on-investment analysis, and drafting application for funding