Improve health outcomes in today's complex world
Government agencies must overcome major challenges to ensure their healthcare programs are sustainable and cost-effective. Our solutions offer customizable options to help you achieve program goals in this fast-paced social, political and economic climate.
The market leader in health services
Medicaid and CHIP beneficiaries served
State and local health programs operated
Legal and medical professionals conducting independent medical reviews
Solving your biggest challenges
Change is everywhere, bringing challenges such as rising costs, aging populations, substance abuse and evolving legislation. We’re here to help you navigate it all, so you can run large programs at peak efficiency and help vulnerable citizens lead healthier, fuller lives.
One resource for everyone
Across the health services spectrum, we have deep knowledge of government programs and populations. We’re conflict free and outcomes focused, so you can be sure we’re completely committed to your success.
Eligibility and Enrollment Services
We manage 70% of all Medicaid and CHIP beneficiary enrollments nationwide.
Screening and Assessment Services
We complete over 1.5 million assessments in the U.S. & U.K. annually.
Provider Management Services
Our solution has earned modular certification from the Centers for Medicare and Medicaid Services (CMS).
We have 100+ contracts in U.S. and handle 5.3 million calls per month across Medicare, Medicaid and social service programs.
Substance Abuse / Diversion Programs
Participants in California diversion program experience just a 13% relapse rate, compared to 50-75% following traditional treatment.
Benefit Reviews and Appeals
We complete 1 million benefit appeals annually for government services, including eligibility, health, disability and workers’ compensation.
Innovative programs to improve care, reduce costs
For more than 20 years, we’ve been helping California’s complex Medicaid program navigate change – from initiating a specialized customer care center to absorbing the state’s CHIP program to improving care for beneficiaries also enrolled in Medicare.
Additionally, our diversion program offers a proven model for overcoming addiction and returning people to work, while our Independent Medical Review program dramatically streamlines the process to resolve appeals.
Friday Five: Legality of Medicaid work requirements still questionable; court hearing continues today
Friday Five: New reporting requirements for Medicare providers go into effect in early November
Friday Five: Social factors present barriers to care management for high-cost Medicaid beneficiaries