Fti Consulting, Inc. · NYSE:FCN
Fti Consulting — AHIP 2023 Medicare, Medicaid, Duals & Commercial Markets Forum
21 slides from Fti Consulting's conference presentation, March 2023
Slide 1: FTI Healthcare Payer
AHIP 2023 Medicare, Medicaid, Duals & Commercial Markets Forum FTI Healthcare Payer Medicaid Managed Care, Medicare Advantage, Commercial and ACA Marketplace March 2023
Slide 2: FTI Consulting: Experts with Impact
FTI Consulting: EXPERTS WITH IMPACT At a Glance .13 Advisor to 9 of the world’s top 10 bank holding $4.9B companies Market Cap1 FTI Consulting is an independent global business advisory firm dedicated to helping organizations 7,500+ 85 Cities manage change, mitigate risk and resolve disputes: Employ
Slide 3: Healthcare and Life Sciences Overview
Healthcare and Life Sciences Overview .13 Who We Are Ecosystem Served 450+ Healthcare clients served Laboratories Industry over the past 3 years Associations Local-Regional Medical Device Clusters PBMs Manufacturers 3:1 to 10:1 Health Health Health Plans Retail Market Leading ROI from Technology Pha
Slide 4: Healthcare and Life Sciences Approach
Healthcare and Life Sciences Approach Our client-centric operating model is designed to deliver tailored solutions and expert capabilities across healthcare disciplines. .13 PEOPLE AND CHANGE REVENUE OPTIMIZATION RISK MITIGATION COST MANAGEMENT Healthcare Provider Healthcare Payer Commercial and Lif
Slide 5: Payer - Medicaid Managed Care
Payer - Medicaid Managed Care
Slide 6: Medicaid Managed Care Services
Medicaid Managed Care Services Strategic thinking and operational and financial discipline drives superior results and value .13 How We Help Our Clients Examples of Certain Select Services We Provide ▪ Expanding growth opportunities through market strategy, procurement ▪ Market expansion strategies
Slide 7: Market Growth & Implementation
Market Growth & Implementation The Medicaid market is fiercely competitive and new entry and expansion must be intentional and executed flawlessly. .13 Growth Strategy Procurement Implementation & Readiness Review Growing your Medicaid footprint is successful For success procurements, your organizat
Slide 8: Operations Assessment, Optimization and Programmatic Readiness
Operations Assessment, Optimization and Programmatic Readiness Yesterday’s innovation is today’s table stakes. We help clients to meet requirements and improve member experience. .13 Capability Assessments and Plans Vendor Community Provider and Community Based Networks Our organizational, business
Slide 9: Financial and Corporate Integrity
Financial and Corporate Integrity Underlying operational excellence and quality program management is data to strengthen outcomes, financial performance, and .13 regulatory compliance. Financial Performance Regulatory & Compliance Disputes & Investigations Exceptional financial performance ensues ma
Slide 10: Payer - Medicare Advantage
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Slide 11: Health Plans & Managed Care – Medicare Advantage & Risk Adjustment
Health Plans & Managed Care – Medicare Advantage & Risk Adjustment .13 How We Help Our Clients Select Services We Provide ■ Performing reviews and benchmarks of ■ FFS and HCC coding training, interim coding accuracy and completeness staffing and audit support Assessing Patient ■ Improving revenue th
Slide 12: Optimizing Reimbursement from Risk Adjustment Participation
Optimizing Reimbursement from Risk Adjustment Participation Medicare Advantage payment methodology relies heavily on hierarchical condition code (HCCs), groupings of ICD-10 diagnosis codes .13 that are predictive of the total cost of care. Improving HCC capture can increase an organization’s calcula
Slide 13: Payer - Commercial and ACA Marketplace
Payer - Commercial and ACA Marketplace
Slide 14: Health Plans and Managed Care – Commercial and ACA Marketplace
Health Plans and Managed Care – Commercial and ACA Marketplace .13 How We Help Our Clients Select Services We Provide ■ Increasing revenue from network ■ ACA risk adjustment contracting opportunities Prevailing ■ Prevailing fee studies ■ Increasing efficiencies from best-in-class Fee Value ■ IBNR re
Slide 15: Value Based Care Offerings
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Slide 16: Evolving Service Models: Value Based Care
Evolving Service Models: Value Based Care The healthcare marketplace continues to transform from a fee-for-service based model to one based on value in which cost efficiency, .13 quality of care and member experience are equally emphasized. Health plans and managed care organizations are forging new
Slide 17: Transitioning to Value Based Care
Transitioning to Value Based Care “We just joined our first Value Based Program – now what?” Healthcare is transitioning to Value Based Care – don’t be caught off guard. .13 FTI Consulting can help mitigate the risk in this transition and foster opportunities for additional revenue. Provider Engagem
Slide 18: Case Study Template
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Slide 19: Medicaid Health Plan Procurement Support, Operational Review and Readiness Review Support
Medicaid Health Plan Procurement Support, Operational Review and Readiness Review Support OUR ROLE: .13 OUR IMPACT: Assisted a Puerto Rico based incumbent Procurement Support Medicaid Health Plan with approaches to RFPs, ■ Dedicated a cross-functional team to help structure, Organized complete and c
Slide 20: Helping an IT solution provider "kill two birds with one stone"
Helping an IT solution provider “kill two birds with one stone” OUR ROLE: .13 OUR IMPACT: FTI is uniquely positioned to advise IT and BPO ■ Compiled and synthesized information about the solution providers on opportunities across the current state of the MES market, with an emphasis of flagging near
Slide 21: Experts with Impact
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