Payment Method Development
On average, the nation's Medicaid programs pay nearly $400 billion annually to physicians, hospitals, nursing facilities, health plans and other providers. It’s no wonder that many states are looking for improved cost-efficiency and greater payment value while increasing access to Medicaid services and quality of care.
Need help with your Medicaid payment services? Partner with us. Unlike many consultants, we already have in-depth knowledge of your MMIS, claims processing systems, Medicaid program and providers.
We specialize in understanding standard industry payment methods such as DRG, RBRVS, APC, APG, RUG and fee schedules. And our experience keeps us at the forefront of new developments such as payment for quality measures:
- Potentially Preventable Readmissions (PPRs).
- Potentially Preventable Admissions (PPAs).
- Hospital Acquired Conditions (HACs).
- Potentially Preventable Conditions (PPCs).
Payment Method Resources
Brochures & White Papers
- Overview: Payment Method Development (PDF, 619 KB)
- Overview: Payment Method Glossary (PDF, 956 KB)
- Overview: RBRVS-Based Payment Methods (PDF, 1.0 MB)
- Overview: How States Pay for Hospital Inpatient Care (PDF, 83 KB)
- Overview: Rate Setting for Nursing Facilities (PDF, 859 KB)
- Overview: Medicaid’s Role in Markets (PDF, 118 KB)
- Overview: How Much Is Enough – Abstract (PDF, 82 KB)
- Overview: Paying for Hospital Outpatient Services (PDF, 1.42 MB)
- Overview: Medicaid Care Coordination and Quality Improvement (PDF, 188 KB)
- White Paper: Medicaid Value Purchasing: Ten Ideas (PDF, 6.0 MB)
- White Paper: Eight Ways to Reduce State Healthcare Costs (PDF, 1.46 MB)