Watch a short explainer on Medicaid Administrative Claiming (MAC)
Increasing Revenue for Safety Net Systems
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Increasing funding for low-income families and children through sustainable Medicaid finance strategies
Underutilizing federal funding for Medicaid activities is common across systems that serve low-income children and families. The result is children from low-income families not receiving the services and care they need. Part of the problem is a Medicaid finance system too complicated for state and local governments with limited bandwidth to effectively navigate. The other issue – even for agencies who have figured it out - is the administrative capacity required to accurately claim for federal reimbursement according to CMS guidelines.
Public Works Alliance has worked with counties, community-based health providers, and state agencies to increase recurring revenue by millions of dollars. It means safety net providers get paid for the work they’re doing and kids and families get access to more of the services they need.
Public Works Alliance has worked with counties, community-based health providers, and state agencies to increase recurring revenue by millions of dollars. It means safety net providers get paid for the work they’re doing and kids and families get access to more of the services they need.
Opportunity Analysis
Step 1 is understanding a system’s claiming potential and determining if the juice worth the squeeze.
Strategy Development
Next we develop a strategy that balances maximizing revenue while managing administrative burden and risk. This is a collaborative process with stakeholders.
Stakeholder/ Staff roll-out and training
Once the strategy is set, we communicate it up and down the organization to ensure a common understand, rally support, and accelerate adoption.
Implementation
While implementing the strategy – amending provider contracts for Direct Charge, tracking staff’s reimbursable time, preparing claims – we’re building the capacity within the agency so they can do it themselves and we can move on.