Medicaid and Long-term Care

Medicaid Bids/Filings

Reden & Anders’ Medicaid staff can assist your organization in completing your state-specific rate development process, including competitive bidding situations or completing the required rate filings. Our extensive Medicaid experience can help your organization maximize your Medicaid program's revenue. Our services range from completing the required forms or bid sheets to an extensive evaluation of your organization’s historical costs and prediction of future expenditures.

Services & Tools:


ASC Calculator
The Reden & Anders ASC Calculator translates the various reimbursement allowances by the Medicare ambulatory surgical category (ASC) groupings into a single average reimbursement allowance per outpatient surgical encounter.
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Excess-of-Loss Rating Model
The Reden & Anders Excess-of-Loss Rating Models develop excess-of-loss premium rates for various populations with two tools; the Hospital Model calculates rates for hospital-only and global coverages and the Physician Model calculates rates for professional coverages.
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Ingenix Health Technology Pipeline
This management tool is one of the few publicly available sources of information that contains both a comprehensive identification of developing health technologies as well as a projected cost impact and suggestions for operational adjustments to minimize costs. It combines the clinical information in the pipeline with financial forecasts so you can anticipate your future medical expenses and plan accordingly.
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Medicaid Consulting Services
Through our expertise, analytical tools, and pricing models, we help health plans, providers, and other public and private groups design and execute innovative, risk-managed strategies for improving access, quality and cost effectiveness in the state-run Medicaid programs.
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Medicaid Tools
Reden & Anders has the experience and tools necessary to assist your organization with your Medicaid at-risk product line. We have helped organizations in more than 30 states with Medicaid analyses. With this extensive experience and a large database of actual Medicaid experience, we have built a solid reputation with state agencies and their consultants.
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Medical Expense Model
The Reden & Anders Medical Expense Models provide users with the ultimate tool for developing forecasts of per member per month (PMPM) medical expenses under a multitude of assumptions. Payers and providers alike will appreciate the flexibility in assessing changes in specialty medical expense budgets due to changing utilization, reimbursement, benefits, and population demographics.
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Reserve Development Model
The Reden & Anders Reserve Development Model is a Microsoft® Visual Basic-based model that delivers quick calculation of estimated incurred claims and resulting unpaid claim reserves. Projections of incurred claims can be developed under a multitude of assumptions.
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Trend Forecast Model
The complexities in current health care costs require a new approach to managing trend forecasting. While all payer groups manage their trend forecasting process, the level of depth varies based on size and complexities of each organization.
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Trend Management Tools
Reden & Anders trend management experts can help you reveal your medical cost drivers, accurately identify health care cost trend drivers, and pinpoint outlier trends that require additional analysis. Our medical cost analytic applications can run complex statistical analyses on your health care data, and represent the findings in a user-friendly, graphical format.
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