Problem
Medicaid is the US health insurance program for individuals and families with low incomes and resources.
Complexity
It is jointly funded by the states and federal government, and is managed by the states. Among the groups of people served by Medicaid are eligible low-income parents, children, seniors, and people with disabilities. Medicaid is the largest source of funding for medical and health-related services for people with limited income.
Solution
Our teams created a scalable, extensible prototype simulation to help identify the right P4P quality measures, and provider / payor / patient path to meeting quality / cost goals. In collaboration with our client, the Center for Strategic Health Innovation in Alabama, we were able to demonstrate the possible successful approaches in a transparent manner understandable not only to Alabama’s state Medicaid leadership but to providers as well.



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