mitigatingloss

Mr. Waldinger, an Associate Manager at PCG, is an experienced Medicaid policy and reimbursement professional who focuses on healthcare operations, mental health and substance abuse policy and integration, and health care reform and its impact on Medicaid programs and providers. As the former Chief Financial Officer and Budget Director for the Massachusetts Medicaid Program, MassHealth, and CFO for the Massachusetts Behavioral Health Partnership (MBHP), Mr. Waldinger was responsible for understanding the fiscal impacts of all programmatic and policy changes, including the building, updating, and tracking of all provider reimbursement calculations, policies, and impacts. At MassHealth, Mr. Waldinger led all financial efforts related to multiple successful State Plan Amendments (SPAs) and 1115 Waiver submissions, including Massachusetts’ landmark health care reform waiver in 2005-6. At MBHP, Mr. Waldinger led efforts to implement a sophisticated inpatient psych hospital pay-for-performance initiative. Mr. Waldinger’s current role at PCG includes heavy involvement in claims processing and Medicaid reimbursement policy transformation. His experience speaks to multiple behavioral health engagements, from provider strategic planning, to statewide behavioral health services assessments, to the development of reimbursement methodologies that incentivize integration of community-based services. Mr. Waldinger’s in-depth understanding of provider costs, cost reporting, cost modeling, and cost settlement experience, provides clients with a unique understanding of the behavioral health system and potential impacts of policy changes. View all posts by James Waldinger