We help clients transform healthcare by solving complex problems.
Empowering State Agencies to Build Smarter, Stronger Medicaid Programs
For state agencies that are redesigning existing programs or launching new initiatives, we help determine authority pathways to support state program goals and identify opportunities to maximize federal financial participation. Our team provides fiscal analysis to support state budget approval and develops and monitors project plans to meet critical state and federal milestones. We create business processes and operational manuals to guide program implementation and design evaluation tools to measure success.
Driving Access and Innovation with State-Based Health Insurance Exchanges
More than 10 years ago, our Founder and other FCG leaders built Rhode Island’s health insurance exchange, Health Source RI (HSRI); since then, FCG has maintained a dedicated team on-site to support HSRI operations.
Learn more about our HSRI team.
Our team has also provided strategic consulting services to other state-based exchanges. Our services include:
- Policy and regulation guidance
- Market analysis and Insights
- Business process improvement
- Technology integration
- Training design and delivery
- Strategic planning and advisory board support
Achieving Better Health Outcomes through Value Based Payment Models
Value based payment models align financial incentives with patient outcomes. FCG has worked with delivery systems in multiple states to design, develop, implement, and evaluate value based payment models to improve the quality of care while addressing rising costs. We have experience across all payers, including in maternity bundled payment programs, value based primary care models, Accountable Care Organization/Accountable Entity programs, performance incentive models for Home and Community Based Service Providers, and most Medicare value based payment programs.
Transforming Behavioral Health Systems to Meet Rising Mental Health Needs
Innovating within the behavioral health system is crucial to address persistent challenges of youth mental health, serious mental illness, and substance use disorders. For Rhode Island, our team conducted a statewide assessment of behavioral health service delivery, identified gaps in meeting community needs, and developed priorities for action. We then supported the state’s planning and implementation of the Certified Community Behavioral Health Clinic (CCBHC) model, a model designed to improve access to coordinated and comprehensive behavioral health care.
Accelerating Progress towards Health Equity and Social Determinants of Health
Using robust data analytic capabilities, we develop models to help our clients assess the impact of programs and services for underserved populations. We create frameworks to help organizations apply an equity lens to all stages of program development, from initiation to design to implementation to evaluation. Learn more about our equity work in the state of Connecticut. One way our clients are advancing health equity is by addressing the social determinants of health, and we have conducted multiple evaluations to determine the impact of innovative housing programs on health care utilization. Learn more about this work in Rhode Island.
Ensuring Robust and Sustainable Long-Term Services and Supports (LTSS)
Navigating the complexities of LTSS requires a deep understanding of regulatory requirements, care coordination, and patient-centered approaches for home and community-based services (HCBS) and residential settings. We help remove barriers to access by simplifying eligibility and enrollment processes for programs that support aging populations and individuals with disabilities. We have helped state agencies plan for transitions to new integrated program models that coordinate benefits and services between Medicaid and Medicare. Our team has also helped clients leverage innovative federal funding strategies to support LTSS workforce development.
Guiding Clients through the Rapidly Changing Health Care Industry and Policy Landscape
Our team conducts market research and policy analysis to identify opportunities for growth and improvement. Recent examples of FCG-led studies include affordability and access studies for health and human service programs, Certificate of Need analyses for new health care facilities or the expansion of existing hospitals or nursing facilities, and a feasibility study for a new Long Term Acute Care Hospital for medically complex patients. We also track changes in federal and state laws and regulations and provide timely policy briefs to help leaders respond and adapt.
