BDC Advisors Offers a Fresh Look at Medicaid

September 9, 2014, Miami – (BUSINESS WIRE) – Featured in hfm Magazine, BDC Advisors’ “Taking a Fresh Look at Medicaid,” the changing Medicaid landscape, coupled with Medicaid’s impact on hospital margins, requires providers to take a fresh look at their Medicaid strategies. Medicaid managed care initiatives dominate the market and hospitals primed for enrollment of Medicaid beneficiaries in capitated, full-risk managed care plans will be the dominant business model. Overall, provider-sponsored Medicaid managed care plans have frequently outperformed for-profit plans with competitive medical loss ratios and lower administrative costs.

Enrollment under the Affordable Care Act (ACA) grew by an average of 18.5% in June, with nine of twenty-six states increasing greater than 30% while states that did not expand Medicaid experienced an average enrollment growth of 4%. Last week the Centers for Medicare and Medicaid (CMS) announced the approval of Pennsylvania’s plan to expand coverage to more than half a million low-income people, becoming the 27th state to do so under the ACA. Additionally more than 7.2 million Americans enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) since Oct. 1, 2013, when the insurance marketplaces launched. The impact of Medicaid expansion is at the forefront of hospitals’ planning agendas and the time to take a fresh look is now.

“A deliberate approach is needed. Medicaid expansion opportunities under the ACA vary. Providers organizing Accountable Care Organizations have a unique opportunity to leverage their clinically integrated networks to established Medicaid plans or partner with payers to develop new products. Others will do better to limit their exposure and focus on the expansion of patient-centered medical homes,”according to Krista Bowers and Bill Eggbeer, managing Directors of the firm and co-authors of the featured story.

As a national healthcare consulting firm specializing in strategic business planning and business diversification for large integrated healthcare delivery systems, academic medical centers, and managed care organizations, BDC Advisors understands the complexities of Medicaid’s expansion. Learn more by downloading the full article.

BDC Advisors is a national healthcare consulting firm headquartered in Miami, which specializes in strategic business planning and business diversification for large integrated healthcare delivery systems, academic medical centers, and managed care organizations.

For more information visit www.bdcadvisors.com. Follow us on Twitter @BDCAdvisors.

For more information, contact:

Pattie.McCann@bdcadvisors.com or cell: 805-428-2039