Medicaid and CHIP

The Lewin Group helps states, the federal government, providers, and managed care organizations provide high-value Medicaid and CHIP programs.

We help our clients design, build, operate, and monitor innovative strategies to improve access, quality, and cost-effectiveness in Medicaid programs and the Children’s Health Insurance Program (CHIP). Additionally, we conduct evidence-based research to guide future Medicaid and CHIP program development. The Lewin Group staff possesses extensive Medicaid and CHIP experience resulting from the wide array of projects conducted for states, the federal government, providers, and health plans. Our experience gives us distinctive and realistic perspectives on the needs and capabilities of stakeholders involved with the provision of public sector health insurance programs.


The Lewin Group has provided Medicaid and CHIP consulting services for public and private clients in more than 45 states during the past decade.

Program Development
  • Help states design, implement, evaluate, and operate Medicaid care management, disease management, and capitated managed care programs
  • Create capitation rates, risk sharing, and reimbursement strategies
  • Develop tailored initiatives to improve services for special needs subgroups
  • Analyze the impact of proposed program design changes on eligibility, access, quality and cost, as well as conduct related actuarial analyses
  • Evaluate the performance of state Medicaid programs and their components
  • Assess the effectiveness of web-based enrollment strategies
  • Prepare public health insurance programs for their roles as purchasers
  • Support development of new eligibility and benefit design structures for Medicaid and CHIP
  • Help health plans and other vendors develop and implement strategies that improve operational performance

 See the full list of Lewin services
 See all Medicaid and CHIP publications


Medicaid Pharmacy Cost and Utilization: Fee-for-Service vs. Managed Care

This Lewin Group report brought hard data to bear on the many policymaking efforts underway in the Medicaid pharmacy arena.

Our report, Comparison of Medicaid Pharmacy Costs and Usage between the Fee-for-Service and Capitated Setting, was funded by the Center for Health Care Strategies and prepared in collaboration with the Association for Community Affiliated Health Plans. The Lewin Group:

  • Presented quantified data findings
  • Described differences in drug spending and usage patterns between Medicaid fee-for-service and capitated managed care programs
  • Provided state Medicaid agencies and health plans with approaches to assess their programs’ success
  • Identified cost-saving opportunities for Medicaid programs and health plans to consider

"Throughout the engagement, Lewin consultants listened to us and delivered superb analyses and thoughtful guidance–not canned solutions.