Medicaid Managed Care Solutions

Conduent's Medicaid Managed Care solutions make healthcare accessible to Medicaid beneficiaries and ensure care coordination and continuity of care. Our end-to-end solution provides Managed Care Organizations (MCOs) the administrative backbone they need to service their members.

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Conduent’s Medicaid Managed Care solutions provide a full service TPA / Platform BPO offering that can perform end-to-end administration of the member block, and also enable the MCOs to provide value added member services like Care Management, Disease Management and Care Coordination, which are usually not available within the Medicaid fee for service framework. These additional services stimulate membership growth for the MCOs and at the same time reduce the cost of care.

Conduent’s point solutions like Utilization Management and Risk Adjustment services allow MCOs to get insights and analytics into the healthcare utilization rate across its member base, and also provide data for a risk adjusted fee structure. Analytics on utilization and risk adjustment are key inputs that drive reserve allocation decisions.

Conduent has helped state Medicaid programs across the country manage population health for over 40 years. We understand the health risks and socioeconomic concerns common among Medicaid beneficiaries. Now we offer the skills and experience we acquired over 4 decades in Medicaid to help your managed healthcare plan succeed.   We bring together the right people, processes and technology to engage members and providers effectively and efficiently, optimize clinical interventions for positive results in population health management, stimulate membership growth and contain medical and administrative costs.

Conduent offers solutions targeting three areas of impact on your managed care business – third party administration, business processing and clinical care.  Taken together as an end-to-end solution set, or individually to focus on pain points affecting your health plan, our solutions can be configured to ensure your success.