Medicaid Financing 2018-11-19T19:34:36+00:00

Medicaid Market Advisory

The Medicaid marketplace is estimated to total more than $500 billion. It consists of more than 50 unique individual state and territorial markets and requires a comprehensive understanding of state and federal regulations and how the interact with one another. The marketplace can be competitive, including a variety of national, state, and regional competitors. With our deep industry expertise, experience in administering state Medicaid programs, we develop, grow, and strengthen business opportunities by collaborating with our clients.

CLIENTS AND SERVICES
Medicaid Market Advisory

The Sellers Dorsey team has advised managed care organizations, private equity firms, vendors to state and managed care organizations, provider groups, health information technology companies, and others interested in expanding or deepening their presence in the Medicaid market. We provide service in these and other areas:

  • Identifying business development strategies and providing relationship support with managed care providers and state Medicaid programs
  • Preparing for and winning new business by drafting, reviewing, and providing technical assistance for responses to requests for information and requests for proposals to ensure responses meet state requirements
  • Succeeding in the Medicaid managed care environment through strategic business development, relationship support, and contracting
  • Identifying and developing business relationship strategies, opportunity development, and relationship support with state Medicaid programs
  • Planning, guiding, drafting, and evaluating RFP responses and other procurement documents to ensure responses meet state requirements
  • Applying the latest in health care trends, best practices, state and federal regulations to your business to seize current and emerging opportunities
  • Succeeding in the Medicaid managed care environment through identifying and developing business relationship strategies, opportunity development, and relationship support with state Medicaid programs
  • Preparing for and winning new Medicaid business by writing, reviewing, and providing technical assistance for responses to requests for information and requests for proposals
  • Identifying the latest in health care trends and regulations, applying them to your business
  • Research and expert insight into potential provider acquisitions in the Medicaid space, involving detailed analysis of market and regulatory factors influencing future performance
  • Due diligence reviews of billing compliance and overall compliance with state and federal requirements
  • Business relationship strategies and support for relationship and opportunity development

OUR TEAM
Medicaid Market Advisors Who Help Realize Opportunities

Our clients are advised by seasoned national experts who have years of valuable experience from working in both the public and private sectors. Members of our team of highly experienced, senior-level experts have run state Medicaid programs, large-scale long-term services and supports (LTSS) programs, and Medicaid health plans. From first-hand experience, our team understands the political, policy, financial, competitive, operational, and systems challenges faced by states, counties, non-profit and for-profit plans, healthcare and specialty providers, private equity and other businesses. Our team understands the trend towards value based purchasing, helping any organization that intersects the Medicaid marketplace adapt to value based purchasing and alternative payment models. The consultants represent some of the experience and expertise that reside within Sellers Dorsey:

Gary Jessee
Managing Director
Pam Coleman
Senior Consultant
Pat Brady, MBA
Managing Director
Martin D. Sellers
Co-Founder and CEO
Nancy Kohler
Senior Consultant
Holly Arbuckle
Senior Consultant
Elizabeth LaMair, JD
Senior Consultant

Gary Jessee assists states, managed care organizations, service providers, and support vendors working within Medicaid. For 20+ years, he’s worked in health and human services at state and national levels, and his successful tenure in Texas state government comprises several leadership roles, including State Medicaid Director.

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Pam Coleman’s expertise is in Medicaid integrated managed care. She’s worked with several states to develop MLTSS and other Medicaid managed care programs, and when she served as Deputy Medicaid Director for the Texas Health and Human Services Commission, Pam administered the Managed Care Operations Department.

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Offering 20+ years’ experience with federal and state health policy, Pat is an authority on Medicaid financing. She provides public and private sector clients with strategic, policy, and technical assistance throughout revenue maximization initiatives and long-term care programs, particularly Medicaid managed care programs.

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Marty is the co-founder and CEO of Sellers Dorsey. With 30+ years’ experience in the public and private sectors, his novel healthcare approaches have impacted nationwide reforms at both state and federal levels, including the development of the groundbreaking universal healthcare program in Massachusetts. Before founding Sellers Dorsey, Marty also helped forge one of the largest state-based government relations firms in the country.

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A resident Value-Based Purchasing (VBP) expert, Nancy works with clients on VBP in Medicaid managed care and Medicaid financing. Prior to Sellers Dorsey, she was integral to PA’s Statewide Quality Care Assessment, and her comprehensive experience includes public health program operations, policy development, implementation, fiscal analysis, and strategic positioning.

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Holly Arbuckle brings a broad range of expertise to the table, including behavioral health services, home and community based services, and transitional care. Prior to joining the team, she worked with Outreach Health Services as Director of Business Development, strengthening their healthcare services to individuals, families, and communities across Texas and other states. She also handled new opportunities in Habilitation and Behavioral Health.

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Elizabeth LaMair has focused her career on federal and state health program design, Medicaid managed care waiver and program development, and program implementation for special populations. Before Sellers Dorsey, Elizabeth served as Director of Healthcare Policy at the Texas Council of Community Centers, providing direction on national, state, and local trends in healthcare delivery, as well as leadership to community-based behavioral healthcare providers.

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CLIENT STORIES
Medicaid Market Advisory Experience

Sellers Dorsey and its team of experts stay abreast of market trends, understand procurement processes, and use this information to grow our clients’ bottom lines. The Sellers Dorsey team has advised insurers, private equity firms, health information technology companies, and others interested in expanding or deepening their presence in the Medicaid market.

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EVENTS AND CONFERENCES
Continual Growth in Knowledge and Relationships

Through our ongoing work and our relationships with key decision makers and thought leaders in the private sector and in state and federal governments, Sellers Dorsey remains well informed of the latest rules and guidance from CMS and trends and innovations emerging from the private sector. Our staff regularly communicates with leaders and staff of organizations and affiliations in the industry, and they attend events with these influencers and decision makers year-round.

Please let us know if you would like to meet a member of our team at an upcoming event. If you are an event organizer and are interested in hearing one of our thought leaders speak to your audience please contact us at [email protected].

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Contact Sellers Dorsey

If you would like additional information or wish to speak to any of our experts about issues facing your managed care organization, please get in touch and we will have a conversation at a time that's best for you.