Medicare and Medicaid Solution
Infuse your Government programs with agility and interoperability
This is a new frontier. States are moving toward a more efficient and outcomes-focused care system. Medicare Advantage must accelerate its adoption of accountable care, bundled payments and additional payment reform options. A health plan's ability to shift its managed care payment models will define its success in the new healthcare frontier.
Medicaid agencies are under increasing pressure to transform their legacy-based Medicaid Management Information Systems (MMIS) infrastructures into member-centric, standards-based systems that are open, Web-based and well integrated with state and federal systems.
Aldera's next generation Medicaid Information Technology Architecture (MITA)-aligned, commercially available off-the-shelf (COTS) solution delivers unmatched flexibility, agility and interoperability to the public sector, so you can innovate your MMIS solution efficiently. So too will its Medicare Advantage solution.
- Optimize operation: From member- and provider-centric services through claims and encounter adjudication, Aldera’s platform enables the complete spectrum of healthcare administration and operational capabilities for the state Medicaid market.
- Fully aligned with Medicaid business process and technology goals
- Performance driven for optimal accountability and planning
- Line level claim and encounter adjudication
- Capitation calculation and processing
- Full interoperability and common standards for state organization collaboration
Find out more about our State Medicaid (MMIS) solution.