Transforming Medicaid Oversight
CoreTechs® empowers state Medicaid agencies to connect fragmented data, validate MCO performance and surface forward-looking opportunities across compliance, cost, quality and equity.
Contract Insights - Make oversight measurable
Model state-to-MCO contracts with full transparency. Track performance against MLR and quality targets, identify measures at risk, and close gaps before dollars are lost.
Contract performance management: Monitor quality, utilization and spend across MCOs; quantify gaps-to-target and dollars at risk by contract and region.
Encounter/data completeness analytics: Score plans on encounter timeliness and completeness to accelerate T-MSIS/EQRO readiness.
Configurable dashboards: Standardize views for plan report cards, contract risk and cost-savings opportunities.
Performance Insights - See what's working (and what isn't)
Understand PMPM trends, link preventive care to utilization, and assess program effectiveness across populations. Identify avoidable ED visits, network leakage, and high-cost drivers to focus interventions where they matter most.
Plan & provider benchmarking: Compare plans and networks on HEDIS, access, and avoidable utilization; isolate drivers and outliers.
Network & access monitoring: Track service use and leakage; flag emerging access issues for targeted action, aligned with evolving managed care rules.
Intervention impact: Measure results from CAPs, incentive programs, and quality initiatives with pre/post and matched cohort views.
Population Insights - Target risk and improve outcomes
Build and monitor custom cohorts for initiatives like maternal health or social determinants of health. Track outcomes, equity, and cost metrics — all in one place.
Risk stratification & gap closure: Identify high-risk cohorts and missed preventive/condition care; prioritize outreach across plans and regions.
Equity & health-related social needs analytics: Screen for disparities; evaluate services and community partnerships; report progress with standardized metrics.
Care pathway intelligence: Reveal where members fall through the cracks and when to intervene for the greatest effect.
Why State Agencies Chose the CoreTechs Analytics Solution
CoreTechs® supports state agencies in their value-based Medicaid transformation journey, aligning technology, data and insight with the mission to improve lives.
Built for oversight: Shared, source-of-truth dashboards for states and MCOs reduce back-and-forth and enable action.
Data-quality first: Embedded rules and monitors support continuous improvement in eligibility and encounter data, aligned to CMS expectations.
Standards-aligned: Configured for evolving CMS managed care transparency and program integrity requirements.
Security & scale: Enterprise controls and performance engineered for multi-plan, multi-program environments.
Achieve Optimal Outcomes and Fiscal Integrity
Strengthen managed care oversight & transparency
Proactively manage cost and quality performance
Institutionalize efficiency and enhance reliability
Advance health equity & health-related social needs goals
Optimize value-based contracts
Gray Matter's CoreTechs gives us the capability to manage provider quality and potential cost-savings in both our Medicaid fee-for-service and managed care populations. The solution provides data-driven insights into claims, clinical, and social needs data, providing a whole-person view, while allowing us to generate scorecards regarding member compliance to our providers.
Stephen Miller
Oklahoma Health Care Authority
I've looked at several different tools, and CoreTechs is the only one that brings in social determinants of health, contract management and population insights - everything we need to be able to manage contract and follow our patients to see where they are slipping through the cracks.
AllHealth Network
Gray Matter showed us how we could reduce manual referrals and accelerate care for patients who require a referral based on clinical conditions and eligibility information.
Novant Health
Based on the reputation of the management team at Gray Matter Analytics and their ability to demonstrate their understanding of physician performance/value-based care, we decided to become the first CoreTechs customer. The proof of concept is continuing, and we have very high expectations on the results.
Henry Ford Health System