This case study looks at a national MCO - the largest MCO in several of its markets - serving nearly two million Medicaid members in northeastern states. The organization's fully-outsourced benefit management model was no longer meeting it's operational and member service goals.
Using data-driven analysis, SKYGEN's Enhanced Benefit Management and Analytics experts took a deep dive into the program to full understand it and and recommend improvement strategies related to fees, benefits and authorizations.
The result? A reduction of $1.08/PMPM in Medicaid dental.
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