Insourcing Medicaid Business Operations

Discover how third-party consulting assistance can help payers move their Medicaid operations in-house without interrupting services or impacting performance. 

Payers without extensive Medicaid expertise may struggle to insource their Medicaid business operations, especially if they are accustomed to relying on a business-process outsourcing (BPO) vendor.

Read this case study to discover how one payer used experienced healthcare consultants to transition its core Medicaid functions—including billing, claims, care management, clinical quality, customer service, finance, risk revenue, and compliance—within six short months.

The consultants updated policies, designed workflows, assisted with staff training, and performed business process and system testing, resulting in a seamless go-live with no impact on the payer’s operations, customer service, or performance standards.

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