Guidehouse works with state government healthcare and social services agencies to develop rational payment models that balance the need to control expenditures with the need to maintain the quality of care and access to the unique services required by certain populations. We offer a comprehensive set of actuarial and payment transformation services that can be customized in ways that fit each state’s unique needs.
How We Help
- Managed Care Rate Setting
- Directed Payments
- Waivers and Budget Neutrality Calculations
- Payment Transformation
- Upper Payment Limit (UPL) Demonstrations
- Supplemental Payment Programs
- Disproportionate Share Hospital (DSH) Payments
- Hospital Rate Development
- HCBS and LTSS Rate Development
- School-based Medicaid Financing
Latest From Actuarial & Payment Transformation
January 26, 2021 InsightsIt's Time for States to Reshape MedicaidAs states emerge out of the pandemic, “business as usual” will look different for many Medicaid programs.
January 22, 2021 InsightsImprove Home and Community-Based Incident Management Systems to Protect Vulnerable PopulationsStates should consider three key strategies when evaluating current systems and processes in relation to the effects of the COVID-19 pandemic.
November 2, 2020 InsightsNon-Emergency Medical Transportation Post-COVID: An Actuarial PrognosisThree Keys to Avoiding Financial Risk and Preparing for the Future of NEMT Care