Poster
At MESC, we co-presented at the poster session with Massachusetts Medicaid program, MassHealth, on:
Poster
At MESC, we co-presented at the poster session with Massachusetts Medicaid program, MassHealth, on:
Infographic
Learn how we collaborate with states to expand benefits for members through sources like Medicare while protecting Medicaid as the payer of last resort.
At ForHealth Consulting, we partner with purposeful organizations to make the healthcare experience more equitable, effective, and accessible. As a part of UMass Chan Medical School, we leverage world-class expertise and deep experience to create innovative financial, clinical, and operational solutions across the health and human services system.
We collaborate closely with healthcare partners to think big about how they can do what they do better—for themselves and the people they serve. Most of all, we believe in the power of a shared purpose; together, we can make healthcare better.
Our Services
We know that many Medicaid members may also qualify for other coverage, increasing their benefits and the state’s savings potential.
Combining advanced analytics with personalized member support, we help states identify untapped third party liability (TPL) opportunities for members, achieving results beyond standard data matching and outreach alone.
Our specialized services complement and supplement existing state TPL activities. As a result, we achieved over a hundred million dollars in new cost avoidance savings for our state partners in the last fiscal year.
Utilizing enhanced data mining and proactive customer service support to identify and enroll Medicaid members aged 65 and older into Medicare
Maximizing MSP data utilization and enhancing operations to facilitate accurate eligibility determinations, transactions, and premium payments
Executing proprietary data assurance, eligibility review, and entitlement correction initiatives to supplement existing Medicare activities and increase the value of Medicare coverage for members and states
Applying high-cost claims analysis with commercial insurance enrollment and coordinating with insurers and providers to expand access for members and savings to states
Providing commercial insurance data integrity and quality improvement assessments to recommend best practices and design customized implementation strategies
Over 98% of Medicaid members engaged by our team agree to apply for Medicare, and more than $190 million in new savings realized for one state since 2014.
One state saw nearly $15 million in new annual cost savings through corrected benefits for more than 1,500 Supplemental Security Income recipients.
With enhanced, one-on-one TPL coordination for Medicaid members with complex medical needs, we lowered a state’s Medicaid program’s potential costs by $60+ million in one year.
Executive Director, Third Party Liability and Benefit Coordination
Jen leads TPL operations, consulting, and customer service initiatives for state Medicaid programs. Her deep knowledge of state and federal data, and direct experience collaborating with state programs, the Social Security Administration, and the Centers for Medicare & Medicaid Services, play a key role in helping clients unlock third party benefits, maximize the recovery of critical resources, and drive meaningful, sustainable savings.
Jen’s work has resulted in member benefit expansions and two national benefit corrections that returned hundreds of millions of dollars to states.
Senior Manager, State Client Relationships
Kerry manages Medicare maximization initiatives for multiple state Medicaid clients, delivering solutions that drive cost savings while ensuring federal benefits are accurately identified, coordinated, and optimized. She leads client relationships and multi-state program operations, developing solutions that enhance Medicaid-Medicare coordination while advancing state program goals.
Associate Director of Benefit Enrollment and Coordination
Matthew directs third party liability benefit coordination and premium assistance activities for state Medicaid clients with a focus on supporting benefit expansions for Medicaid members with disabilities and chronic conditions. He leads initiatives to identify access to commercial health insurance options, including employer-sponsored insurance and COBRA.
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