New Optimity Medicaid Mega-Reg Tool Enables Rapid Assessment And Identification of Compliance Gaps

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Proprietary Tool and Assessment Allows Companies to Quickly Identify Changes Needed to Be Compliant with New Rule

“Helping our clients prepare for the recently released Medicaid Managed Care Rule is crucial to their long-term success,” said Doris Stein, Partner and Healthcare Practice Lead at Optimity.

Optimity Advisors (Optimity) just unveiled a new Medicaid Mega-Reg Tool and Assessment that enables Optimity to rapidly determine the level of compliance of health plans and managed care organizations (MCOs) with the extensive requirements of the Medicaid Managed Care Final Rule. The tool includes a comprehensive inventory of the Mega-Reg and drives a targeted and efficient assessment, providing summary views with insight into the level of compliance for each requirement category and overall. Optimity is a global strategy and operations firm that helps companies adapt to rapidly changing markets.

“Helping our clients prepare for the recently released Medicaid Managed Care Rule is crucial to their long-term success,” said Doris Stein, Partner and Healthcare Practice Lead at Optimity. “Our team of healthcare experts have examined the extensive rule, identified the potential pain point areas and designed a simple tool to allow Optimity to easily and quickly identify health plans’ compliance gaps and provide recommendations to achieve compliance.”

The changing landscape in Medicaid, and the complexities of state environments, present significant challenges and opportunities for states, payers and care delivery organizations. The new Medicaid and CHIP Managed Care Final Rule introduces sweeping changes that will significantly transform Medicaid. The final rule, also known as the “Mega-Reg,” is the first major change to Medicaid rules since 2002. It builds on Medicaid reforms introduced by the Affordable Care Act (ACA) and pushes to align Medicaid with Medicare Advantage and Exchange regulations. With the clock starting to tick on the final rule’s phased implementation timeline, states, health plans and providers will need to rapidly assess the way they currently deliver Medicaid, and take aggressive measures to define and execute strategies to meet the requirements of the new federal legislation.

Optimity’s proprietary Mega-Reg Assessment helps clients determine compliance gaps and quickly identify and evaluate strategies to address the Mega-Reg requirements. The comprehensive offering includes Optimity’s Rapid Assessment approach to collect information on current Medicaid operations and practices, perform a preliminary compliance assessment, conduct accelerated design workshops to validate the assessment findings, and identify and prioritize compliance actions. As a result, clients receive high-level compliance strategies and recommendations by requirement area, as well as a proposed implementation roadmap.

To learn real world examples on how to ensure compliance, register for Optimity’s complimentary webinar “Medicaid Mega-Regs: Tips to Assess Your Organization and Become Compliant” on September 28th at 1 pm ET / 10 am PT.

About Optimity Advisors
Optimity Advisors is a specialized advisory firm that combines deep industry expertise and integrated solutions to help companies enhance stakeholder value, improve operations, and address performance and risk related challenges. Optimity is comprised of professional advisors around the globe with deep domain expertise in strategy, innovation, information management, business and digital transformation. Optimity drives business solutions through creative design, advanced analytics and analysis, and technology enablement. We help clients digitally transform their business to monetize data and intellectual property, automate operations through intelligent processing and cognitive technology, optimize customer interactions, accelerate revenue realization through digital product and services launches, and design innovative business models for rapidly changing markets. Learn more at

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Kelly Hamilton
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