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

• Actuarial
  
  • 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