A new national health plan in a state Medicaid market wanted assistance on achieving multiple operational and technical goals.

The Collaboration

Sellers Dorsey worked with the health plan to define its main goals including:

  • Strengthening the health plan’s relationship with state Medicaid leadership
  • Advancing value-based purchasing arrangements with providers through technical assistance
  • Developing communication strategies to educate state leaders, legislations, and other stakeholders about the plan
  • Improving operational efficiencies to ensure contract compliance

The Results

Seller Dorsey supported the client’s negotiation strategies with the state using analyses of provider rate adjustments and capitation rate development documents. Our team also developed the plan’s internal review process for state letters of direction. Our work with this health plan has led to it avoiding financial penalties by meeting or exceeding value-based purchasing contractual requirements.