SCALE was engaged by a Dental Services Organization (DSO) participating with a Managed Care Organization (MCO) providing dental services to Medicaid recipients for which a rate reduction was imminent. The engagement included providing financial analyses to quantify service line impact, payer contract review and strategy development to improve their rate position.
SCALE Payer Strategy and Consulting business segments conducted a thorough financial analysis
of proposed rate reductions supported by contract review, a regulatory assessment, and research
on the Medicaid network in the state.
SCALE developed a comprehensive strategy to counteract proposed rate cuts:
As a result of discussions with the MCO, rate reductions were brought down by 50% and a Memorandum of Understanding was negotiated to solidify non-contractual terms and strengthen a continued partnership.
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