Services for Public Sector Organizations

PHPG provides a wide range of services to State, County and City governmental agencies.   Our consultants have the experience and expertise to assist these agencies in the following areas:

Operations Management

Claims and Encounter Analysis

Development, implementation and ongoing administration of all types of Medicaid/SCHIP managed care programs

Analysis of legislative and policy issues

Litigation support services

Development of Section 1115 Demonstration Waiver proposals, negotiation of Terms and Conditions, and preparation of the Operational Protocol

Development of HIFA Waivers and 1915(b) and (c) waiver applications

Title XIX claiming systems for school-based services

Design of reimbursement methodologies for managed care, including performance-based systems

Financial Management

Development of budgets

Analysis and trending of program financing requirements

Development of Upper Payment Limit calculations

Development of Budget Neutrality analyses for Section 1115 Demonstration Waiver Proposals

Competitive Procurements

RFP development

Scoring Methodologies and Tools

Training for evaluators

Technical assistance with evaluation of proposals

Readiness reviews and site visits

Performance Monitoring

Satisfaction survey development and analysis of results

Development of Performance Standards and Measurement Tools

Assessment Tools for special needs populations

Facility site reviews for contractors

Periodic site visits for monitoring managed care plan performance

Analysis of HEDIS data

Development of Provider Report Cards

Specialized Initiatives for Special Needs Populations

Program development and implementation for managed care models for:

• Developmentally Disabled persons
• Frail elderly population
• Persons with AIDS
• Seriously Mentally Ill adults
• Seriously Emotionally Disturbed children
• Other children with special health care needs