OUR TA

Medicalincs provides TA services that support Medicaid health plans, providers, and beneficiaries. Our Suite of Services include value-based care solutions, primary care innovation, workforce training, and program management.

Our team has a good balance of understanding the importance of achieving performance results and financial impacts while keeping in mind that the patient should be at the core of everything that we do. We understand the challenges that can be faced in the complex world of healthcare that is why we are here to help you and your organization link silos, sustain systems, and save lives.

WHAT MAKES THIS VENDOR UNIQUE

  • We are a Centers for Medicare and Medicaid Services-approved Care Transformation Organization; and have ongoing hands-on experience with data-driven care management and quality improvement solutions.
  • Medicalincs delivers positive sustainable results:
    I. Improved Utilization: 40% reduction in hospitalization and 30% in ED visits
    II. Achieved 90% Patient Satisfaction in CG-CAHPS Survey & Program-specific surveys
    III. Excelled in project performance obtaining a 1.2 Cost Performance Index,92% team productivity, and 99.5% deliverables approval
    IV. Guaranteed return on Investment; by employing a multifaceted, customized, approach to solutions (3.1 ROI)
    V. Engaged workforce development achieved 97% training attendance rate, 35% knowledge gain, and 80% knowledge application readiness
    VI. Always Ahead and always evolving in this complex industry; and our experts work in harmony with leadership, clinical, & business
  • Our TA applies our E.A.I.D Model, which is based on the person to person (P2P) approach with our human centered process re-engineering.

A SUCCESSFUL TA EXPERIENCE

A Medicaid health plan had issues with maintaining their Medical Loss Ratio and associated health outcomes (clinical measures and patient satisfaction scores); and sought to develop and implement an Ambulatory Intensive Care program within a Primary Care Practice to manage the care of its’ highest risk-highest cost patients. Our expert led a multi-disciplinary team – consisting of admin staff and clinical staff – to design, implement, and monitor a new Advanced Primary Care Medical Home delivery model.
Some key results include increasing timeliness of medical record transfer to TPA which resulted in increased staff satisfaction, 5,415 staff hours saved in 4 months, and a cost savings of $2M per year. Moreover, in one year, we assisted with reducing emergency department visits by 28% and hospitalization by 40% for program beneficiaries. Lastly, we were able to improve the following among the member population: 34% improved in medication adherence, 43% increase in cancer screening, 23% increase in hypertension control, and a 6.1 PAM score average which resulted in cost savings of $1M and a 2:1 ROI.

The statements in this document are made solely by Medicalincs. No statement in this document should be construed as an official position of or endorsement by Abt Associates Inc. or the Massachusetts Executive Office of Health and Human Services.

ABOUT MEDICALINCS

Medicalincs mission is to link silos in the healthcare system — to achieve the most cost-effective, high quality, and continually-improved care delivery that preserves and saves lives! Medicalincs is a specialized healthcare advisory and population health management services firm that supports commercial and government health organizations to improve performance and health outcomes. Medicalincs was established in 2017, on the philosophy of casting a stone to create many high-yielding ripples!

ORGANIZATION FUN FACTS

  • Our values make us THICK – Trusted, Hearty, Innovative, Committed, and Kaizen!
  • We chair and fund a Care Resource Fund that provides financial assistance to Medicaid beneficiaries to purchase services or products that are not covered by their insurance.
  • We are very agile, flexible, and accommodating to our client’s needs.
  • Our team members are trained and certified in Care Management, Project Management, Change Management, Lean Six Sigma, continuous quality improvement, data analytics, and community health support.

QUOTES FROM CLIENTS

  • “This program has really transformed how we address our highest risk patients; and the ROI is quite promising.” – Health Plan Board of Director Member
  • “We Look forward to working with your team in the New Year; Thanks for all you have done for us.” – Executive Director
  • “Your primary care transformation training especially on change management and how to achieve buy-in among healthcare providers was very informational. I feel better equipped to engage providers and coach them through their transformation. “ – Practice Transformation Coach

DOMAINS:

Actuarial and Financial

Care Coordination/Integration

Community-Based Care and Social Determinants of Health

Consumer Engagement

Flexible Services

Health Information Technology (HIT)

Performance Improvement

Population Health Management

Telehealth

Workforce