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, 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
  • 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, health care 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
Sharen Ludher
Director
Elizabeth LaMair
Senior Strategic Advisor
Janice Fagen
Senior Strategic Advisor
Karen Brach
Director

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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Sharen Ludher serves as Director of Consulting Operations for the firm’s work in Medicaid managed care and long-term services and supports. With experience in both the public and private sectors, Sharen helps clients through strategic business intelligence and relationship support. In her previous role as Senior Advisor to the Deputy Executive Commissioner for Medical and Social Services at the Texas Health and Human Services Commission, Sharen provided critical thought, analysis, and recommendations on a wide range of topics.

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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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Janice is a seasoned expert and leader in the health care industry. She is the former Vice President of Medicaid Operations at Blue Cross and Blue Shield of Texas. Janice’s areas of expertise include Medicaid managed care, RFP and state procurements, managed care contract development, solicitation support, value-based care strategy, business development, health care operations, and enrollment.

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Karen is a former managed care executive with more than 20 years of leadership experience in the health care industry. She uses her areas of expertise including managed care, Medicaid policy, RFP and state procurements, and mergers and acquisitions to support Sellers Dorsey clients. Before joining Sellers Dorsey, Karen was the President and CEO of Meridian Health Plan for four years.

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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.

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 info@sellersdorsey.com.

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.

     
     
     
     
    Sellers Dorsey is tracking and assessing the large volume of information coming from the Biden Administration, Congress, CMS, and state governments regarding Medicaid. Sellers Dorsey publishes these updates in a weekly newsletter called the Sellers Dorsey Digest.
    Sellers Dorsey Digest.
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