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Successfully helped start up three Medicare-Advantage health plans obtain CMS approval in the United States and Puerto Rico (2006-2010).
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Effectively assisted Medicare-Advantage Plan in obtaining service area expansion from CMS (2010).
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Vendor selection assistance reduced administrative costs by 70% while doubling manufacturer rebates (2009).
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Completed 24-month clinical project from concept to implementation and operations in just 18 months - 20% under budget (2006-2008).
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CMS ranked Bayham Consulting lead Quality Improvement Project that involved several MA-PDs, PDPs, State Medical Society, State Pharmacy Association, Medical Schools, Pharmacy Schools, QIOs, State (2006-2007).
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Developed and implemented provider and member-specific interventions for several managed care organizations and physician groups at risk for prescription drug costs that tripled generic utilization of targeted drugs in selected therapeutic classes in just 90 days with over-all generic utilization rates continuing to rise even today (2006-2010).
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Provided oversight of acquisition of a regional health plan by a national plan, resulting in no disruption of care to members (2006).
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Over ten years of CMS Audits. Zero deficiencies. No Corrective Action Plans ever required.
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Pharmacy costs were always consistently lower in State Employee Group Benefits program than other options from other carriers.
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CAHPS member satisfaction in Top 10% nationally (2006-2008).
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CAHPS pharmacy scores always higher than rest of plans in service area. (2006-2008).
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CAHPS pharmacy scores consistently higher than both regional and national averages (2006-2008).
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Successfully aided non-profit group in gaining approval for a CMS demonstration project.
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Remembering Hurricaine Katrina just 3 years earlier - newly-elected Governor Bobby Jindal went before the television cameras when Hurricane Gustav threatened Louisiana. He wanted to ensure that Louisianians would be able to get an emergency supply of their prescription medications – especially the elderly and disabled, who were the first to evacuate. So, he called on the Medicare QIO for the state of Louisiana. The QIO called on Bayham Consulting (2008).
