SERVICES WE PROVIDE

IDENTIFYING SOLUTIONS FOR MEDICARE & MEDICAID REIMBURSEMENT

AHCV focuses on helping healthcare providers identify innovative solutions in today’s challenging Medicare & Medicaid reimbursement environment. In order to fulfill our Mission of delivering innovative solutions that improve access to care, we help healthcare providers overcome current challenges while simultaneously preparing them for those that are possible in the future.

To overcome the present and prepare for the future, the AHCV Team:

  • Focuses on community benefit and patient needs
  • Delivers tangible solutions to abstract risks
  • Monitors complex statutory and regulatory changes in Medicare & Medicaid
  • Creates innovative processes that measure internal financial risk under Medicaid regulations

WHEN CAN YOU BENEFIT FROM OUR HELP?

Healthcare providers can benefit from AHCV’s work in a variety of different situations. Our cross-functional team of experts has both the experience and knowledge to help you navigate through the challenges you currently face as well as the unforeseen challenges you may soon face. Because our team includes former head government regulators, former top executives from both private and public hospitals, and other leading strategic consultants, we are confident we can lead your entity through just about any challenge.

Some of AHCV’s most recent projects include helping healthcare providers with the following:

  • Working with multiple private general acute care hospitals in Texas to access federal financial support under the Texas Section 1115 Medicaid waiver, including the uncompensated care pool and the delivery system reform incentive payment pool
  • Creating Local Provider Participation Funds which have allowed previously unfunded areas to access previously untapped Medicaid payment potential consistent with state and federal law
  • Developing partnerships between medical schools, hospitals and state government to leverage existing state funding through the Medicaid program
  • Developing managed care organization (MCO) pass-through payments and other payments for providers made through MCOs
  • Examining the impact of health system structural changes on Medicare and Medicaid payments
  • Resolving swiftly and efficiently bureaucratic Medicaid SNAFUs
  • Conducting a data-mining project for various hospitals that improved internal financial efficiency and helped access additional financial support under the Medicaid DSH program
  • Developed an assessment of demand for behavioral health services in Harris County
  • Prepared financial projections that measure and assess the potential impact of changes in the Medicaid DSH regulations
  • Worked with consultants and lawyers across the country to successfully negotiate a settlement of a CMS deferral of federal financial participation
  • Worked with a children’s hospital to identify internal operational and financial efficiencies that will allow for them to receive supplemental payments under new federal regulations
  • Developed multiple databases that served as the basis for multiple hospitals to successfully appeal initial DSH payment estimates