For more than 20 years, Guidehouse has brought best practices and thought leadership from its healthcare commercial consulting practice to its Federal government clients. Our professionals apply deep experience from a number of healthcare segments such as physician groups, health systems and health plans, to create sustainable solutions to healthcare issues for its Federal clients.
Guidehouse Healthcare Federal Services is at the forefront of national healthcare issues – we help the Federal government implement programs and policies in response to the ACA, healthcare reform and military/veteran health initiatives.
Guidehouse Healthcare Federal Services is dedicated to the needs of the Federal government. Our core expertise bridges the gap between management, technology, engineering and finance to address complex initiatives. Our teams ramp up to deliver services quickly and efficiently. Federal agencies rely on our rapid response capabilities and our one-stop shop for projects that require the right blend of professional skills and subject matter expertise.
We provide strategic services aligned with best practices and emerging technologies to support government entities as they design, implement and monitor Federal healthcare policies and initiatives.
Federal Service Offerings
Program Design and Implementation
Guidehouse has experience planning, designing, implementing and evaluating healthcare delivery systems for both public and private payers. We assist government agencies in developing strategies to address constituency needs and program gaps. Strategies range from program and policy changes to information systems changes, reporting, outcome monitoring, development of innovative programs, identification of new administrative contracting arrangements and others.
Guidehouse has deep “hands-on” involvement within the ACA’s new Insurance Marketplace (formerly Exchange) sector. We are currently helping the government implement the Marketplace-related CO-OP (Consumer Operated and Oriented Plan) Program. We conduct readiness assessment reviews; provide health plan technical assistance; and provide education and support regarding licensure issues, QHP (Qualified Health Plan) certification, eligibility and the premium tax credit and cost-sharing reduction programs
Likewise, we are assisting many of our state, insurer and provider clients to understand impacts of the ACA beyond the Marketplace, including financial and operational impacts of the ACA on consumers, insurers, providers and state agencies.
Medicare / Medicaid
Guidehouse Healthcare Federal Services provides innovative ideas and solutions to help health and human services organizations develop new and manage existing programs. We lead the field in the areas of state coverage expansion initiatives, Medicaid reform – including Accountable Care Organization (ACO) and Patient-Centered Medical Home (PCMH) implementation, payment system design, managed care implementation and operation and the development and financing of consumer-directed services for public payers.
Program Integrity and Program Compliance (Fraud, Waste and Abuse)
Guidehouse’s expertise stands from our experience as a consulting firm – we help our clients not only to design new initiatives but also to execute these government healthcare solutions. Our work involves analyzing significant amounts of survey data, facilitating stakeholder meetings, coordinating data collection and conducting on- and off-site reviews, risk identification and developing recommendations for areas where vulnerabilities or opportunities for improvement can be identified.
Healthcare Quality Measurement Development and Implementation
Guidehouse brings extensive experience applying quality measures in real-world, practical healthcare environments. We are on the front lines with quality measure implementation – we understand the challenges and issues that healthcare organizations face when striving to use quality measures in a sustainable, meaningful way. We bring expertise that improves the likelihood for organizations to adopt and apply quality measures in support of tangible performance improvement.
Advanced Data Analytics
Guidehouse is the preeminent firm assisting government agencies in developing data analytics and mining techniques to inform strategic thinking, create “what-if” scenarios and conduct predictive modeling. We are experts in integrating financial analysis and quality metrics from claims data to identify performance trends and benchmark comparisons.