A robust Utilization Management (UM) and Quality Improvement (QI) program is the cornerstone of continued financial viability of state Medicaid programs. Delmarva Foundation’s expertise, innovative approaches, and extensive experience in QI and UM distinguish us from other companies. We deliver utilization control services that actively help improve healthcare quality and delivery while addressing the goals and performance of each of our state clients. Also, in our experience with the federal program integrity contracts, we have gained expertise in fraud, waste, and abuse.
Delmarva Foundation is dedicated to protecting the fiscal and clinical integrity of health care systems. Our resources include statisticians with PhDs, predictive modeling specialists, medical directors, registered nurses, certified coders, investigators, and business analysts. Their experience with evaluating Medicaid health care outcomes and service delivery includes such services as personal care and family planning, home health, nursing facility, physician, dental, and inpatient and outpatient hospital services.