Medicare

In the last few decades, the program has transitioned from a prudent fee-for-service payer to one that actively invests in health care quality, efficiency, and delivery system transformation through value-based purchasing. Mathematica has played a critical role in designing, implementing, and evaluating Medicare initiatives such as benefit reforms, payment arrangements, and beneficiary outreach and engagement. We help our clients understand what’s working by assessing the quality of encounter data, finding ways to further improve primary care and care coordination for Medicare beneficiaries, determining how to communicate with Medicare beneficiaries about quality of care, and experimenting with different approaches to authorizing Medicare coverage for services. By running learning collaboratives and creating resources such as toolkits, we support the translation of policy into practice for organizations such as Accountable Care Organizations participating in Medicare’s payment models. Our decades of experience working with the Medicare program give us extensive knowledge of Medicare coverage and payment policies and a strong understanding of the diverse needs of Medicare beneficiaries.