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, including a new rating structure for Assisted Living providers that is designed to support targeted rebalancing goals.
  • 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
  • Behavioral Health System Review: Conducted qualitative and quantitative data analyses of RI behavioral health system to identify and develop priority policy options for the state.

We are eager to learn more about your policy needs and how we can work together.