Your state may be able to leverage the MedReform Medicaid Care Management Service to receive a Federal Medicaid Transformation Grant (MTG)
On July 25th, 2006 CMS announced the creation the Medicaid Transformation Grants (MTG) of up $150M (’07-’08) to jumpstart state programs for the rapid adoption of Medicaid reforms and the associated program cost savings. No State matching funds are required for these special grants, but states must submit applications to CMS by September 15, 2006.
ISCorp and NexPro Technologies have prepared a package for states that wish to take advantage of this special MTG funding including a prepared MTG application that you can use to apply for your grant. Your MTG can be used for the implementation of a MedReform solution that will:
- Reduce state Medicaid costs for home health services by millions of dollars annually
- Increase the continuity of services provided to patients
- Eliminate fraud and waste
- Reduce the cost and effort to manage Medicaid programs
- Meet Federal budget and compliance regulations
MedReform MTG Program Overview
Deficit Reduction Act and Medicaid Transformation Grants (MTG’s)
The Deficit Reduction Act (DRA) of 2005 (S.1392, Jan 27, 2006) identifies required changes to the Medicare system to lower costs and improve efficiency, service and accountability of Medicare programs. On July 18th, 2006 the Center for Medicare and Medicaid Services (CMS) created the Medicaid Integrity Program (MIP) to undertake initiatives to drive lower costs and improved service for Medicare.
CMS Administrator Dr. Mark B. McClellan, M.D, PhD describing the new MIP program: “A comprehensive and systematic approach to combating the misuse of taxpayer funds is key to helping lower health care for Medicaid beneficiaries … Together with our state partners, we are implementing unprecedented steps to assure that Medicaid funds do not support criminal activities within our system … These strategies will yield significant Medicaid savings and help sustain the program.”
On July 25th, 2006 CMS announced the creation the Medicaid Transformation Grants (MTG) of $150M (’07-’08) to jumpstart state programs for the rapid adoption of Medicaid reform and the associated program cost savings. Funding is available for states to develop improved efficiencies by:
- Reducing patient error rates
- Reducing waste, fraud, and abuse under Medicaid
- Improving coordination of care through care management programs including the reduction in duplicated effort or services
- Reducing costs through, improved efficiencies, reduction in billing errors, accurate delivery of the most appropriate prescription drugs and health services to individuals
MedReform Solution for MTG Applicants
ISCorp and NexPro have developed a unique package that will help states apply for an MTG and leverage the Federal funding provided under the MTG to build state-of-the-art Medicaid solutions that have been proven to reduce Medicaid program expenses for home services by 10% or more:
- Package includes prepared application for MTG funding for your state
- Development of specific project plans and customization of project, software, and services to meet specific requirements of state Medicaid programs
- Two step pilot to rollout new technologies and demonstrate the efficiencies and savings
- First two years 100% funded by the Federal MTG, very low cost and risk to state
- After 2 years, state can decide to expand program (and savings) or discontinue
- After first two years program costs are about 10% of typical savings
- Substantial reduction on state costs to manage, audit, and administer Medicaid program
- Detailed audit trails and management reports allow administrators to track services delivered under Medicaid home programs down to the minute and assure compliance with state and Federal regulations.
How does MedReform Work?
The MedReform service is a turn-key application service that is customized to meet the speficic requirements of each State’s Medicaid home care program(s). The service includes all of the staff, hardware, software, facilities, and operations necessary for your state to leverage the capabilities of the solution.
MedReform will:
- Drastically reduce the cost of services being provided by improving efficiency and virtually eliminating fraud and abuse
- Immediately improve the coordination, continuity and validity of services being provided
- Change the attitudes of providers from agency owner to direct care worker by proactively promoting accountability and responsibility
- Provide your state with the tools necessary to use centralized data and exception reporting to directly manage your providers and programs literally from your desk
This is accomplished through the use of a centralized data-driven, integrated computerized interactive voice response solution that verifies the provider and exact time of service provision. This information flows through extensive checks and balances, is then integrated with electronic billing and payroll thus eliminating “honor system” charting and instituting “time clock” charting.
MedReform is currently being used for all types of home-based services. However, it was designed using a centralized database that has the ability to easily add or remove modules. Therefore, we are capable of enabling and implementing the addition of any Medicaid reimbursable service your state administration may desire.
MedReform aggressively strives to continually add and upgrade features keeping in mind that fraud and abuse is always evolving. Our most recent developmental system upgrade phase includes integrating a GPS component to track transportation services. ISCorp and NexPro Technologies have the proven expertise to synergize any foreseeable customization upgrade your state may require.
Proven Results
ISCorp and Nexpro have conducted a pilot program for the State of Wisconsin. This pilot demonstrated a 10% reduction in units billed through the program. A significant improvement over units billed through the current paper “honor system” charting. In Wisconsin, this equates to approximately $50,000,000 in annual savings. This projection is based on Fiscal Year End (FYE) 2005 for Medicaid Personal Care services.
For more information contact Mike Weber at 262-240-7777 or getresults@iscorp.com
About ISCorp
ISCorp is a leading provider of On-Demand applications and data processing solutions for the Financial, Healthcare and Education markets. ISCorp Intelligent On-Demand solutions evolve and adapt to changing business, technology and security requirements. Our specialized expertise in building On-Demand products provides instant access to the latest capabilities with little to no overhead, allowing customers to focus time and resources on strategic initiatives instead of daily application management issues.
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Integrated Systems Corporation
10325 N. Port Washington Rd., Mequon, WI 53092
(262) 240-7777 getresults@iscorp.com
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