Government and compliance solutions.
Supporting Medicaid clients since 1992, Medicare Part D since 2006, Marketplace Plans since 2014, and Medicaid Fee for Service since 2021.
EXPERIENCE & SUPPORT
A proven partner.
Government programs can be complex to manage and often serve populations with higher health risks and costs. MedImpact has decades of experience supporting highly regulated plans. Our dedicated Government Programs and Services team provides focused support to clients that offer regulated plans, including:
- Medicare Advantage Prescription Drug (MA-PD)
- Standalone Prescription Drug Plans (PDP)
- Employer Group Waiver Plans (EGWP)
- Medicare-Medicaid Plans (MMP) including Programs of All-inclusive Care for the Elderly (PACE), and Special Needs Plans (SNP)
- Retiree Drug Subsidy (RDS)
- Managed Medicaid
- Fee-for-Service Medicaid
- State or Federal Marketplace Plans
MedImpact clients achieved higher Star Ratings on average than those of any of the four largest PBMs in the key categories: Diabetes, Hypertension, Cholesterol, and Statin Use.
Compliance and oversight.
MedImpact’s comprehensive Medicare program supports more than 35 Medicare-specific programs. We launched a fully integrated Rapid Response Team (RRT) to provide expert audit services and universe handling. Our combination of clinical, operational, and regulatory expertise has helped MedImpact government program clients perform better in audits, achieve more stars, and earn greater bonus payments. In fact, MedImpact clients achieved higher Star Ratings on average than those of any of the four largest PBMs in the key categories: Diabetes, Hypertension, Cholesterol, and Statin Use.
Proprietary technologies.
MedImpact has invested heavily in technologies to support government programs. Our proprietary Part D-specific formulary system was built from the ground up with a single source of truth, resulting in consistency with reporting and adjudication. Coupled with our patented pre-processing drug list logic that automatically flags and sorts claims for processing, speed, efficiency, and accuracy, these technologies provide the first step in achieving great Prescription Drug Event (PDE) acceptance rates. For Medicaid plans, our MedEncounter™ application allows plans to track and oversee the entire encounter process, resulting in a higher encounter acceptance rate.
Proven results
ON A MISSION
Connected care.
Every year, we invest hundreds of millions of dollars in technology, people, and solutions to make healthcare benefits more connected, personal, and affordable.
