Services + Solutions | Medicaid

Together with our Blue Plan owners and clients, we’ve been serving the Medicaid population for more than 10 years. Our shared sense of purpose encourages collaboration and aligns best practices.

Section divider


The right fit for you

Our experienced Medicaid team works with clients through a state-by-state approach. With comprehensive Medicaid services and client-specific support based on each state’s regulatory needs, we help you design a Medicaid pharmacy program that’s right for you and your members.

The right fit for you

Section divider

Keeping medicine more affordable

Keeping medicine more affordable

We promote efficiency and cost savings by starting with program-specific formularies (drug lists) and benefit designs. We also add state-specific networks and pricing, and specialty drug management focused on Medicaid-specific populations. 

Section divider

Operations and compliance focused

Our Medicaid compliance team works directly with plans on a state-by state basis that optimize solutions, focus on continuous improvement and find cost savings. Our plans feature the detailed compliance solutions you need, including:

  • State-level policy monitoring
  • State-and program-specific fraud, waste and abuse

Operations and compliance focused

Section divider

Industry-leading clinical programs and quality management

We pay attention to overall plan improvement and customer satisfaction. Our industry-leading clinical and adherence programs help members get, and take, the medicine they need.

  • Utilization management helps members get the right medicine at the right time.
  • Program-specific quality improvement plans help our programs meet the needs of members now and in the future.


 

 

 

 

 

 

 

Reporting and analytics

Our convenient reporting and analytics tools give you customized, online reporting and quarterly Medicaid updates.