FOX Government Consulting

Government Consulting

FOX Systems, Inc. (FOX) has provided services to federal, state, and county government agencies including the Centers for Medicare & Medicaid Services (CMS), over 35 of the state Medicaid agencies, and state and county public health departments, mental health departments, developmental disability departments, welfare agencies, and managed care organizations (MCOs).

The broad spectrum of programs we have supported include Medicaid, federal substance abuse services, state-funded health programs, public health, WIC, immunization programs, mental health, managed care, epidemiology, and others.

FOX is able to provide Government, Medicaid & MMIS Services to your organization by providing solutions in the following areas:

Management consulting and strategic planning such as the development of statewide managed care strategies built around comprehensive methodologies such as the Zachman Enterprise Architecture ™ framework and Information Engineering (IE)
System feasibility studies including “build versus buy” studies, systems alternatives analysis, and detailed cost-benefit analyses based on Total Cost of Ownership (TCO) concepts
System development of healthcare systems supporting functions such as long term care certifications, pharmacy prior authorizations, drug rebate reporting, healthcare employee criminal history screening, fraud and abuse detection, HIPAA assessment and gap analysis and other applications
System requirements analysis incorporating functional, data, technology, and operational models supported by CASE and other automated tools
Development of procurement deliverables such as Advance Planning Documents (for federally-funded systems), Requests for Proposals (RFP), Requests for Information (RFI), Requests for Quotation (RFQ) and other solicitation documents
Proposal evaluation and contract negotiation support services including development of evaluation methodologies and training materials, training of client evaluators, and support during contract negotiation with vendors such as independent scoring and development of contractual Service-Level Agreements (SLAs)
Independent Verification and Validation (IV&V) including vendor project implementation monitoring, ongoing risk assessment, review and assessment of development deliverables, independent test planning and review, and other services based on IEEE 1012-1998 standards
Development of operational documentation and associated user training

Dr. Susan Fox is past Chair of the Private Sector Technology Group, which advises the Centers for Medicare & Medicaid Services (CMS) on Medicaid systems and technology. She also is one of the nation’s leading Health Insurance Portability and Accountability Act of 1996 (HIPAA) consultants, and has worked with CMS, state Medicaid agencies, and other healthcare organizations on implementing the requirements of this federal legislation.

FOX has consulted to many federal, state and local government agencies including:

Federal Centers for Medicare & Medicaid Services (CMS) where we have had the privilege of participating in four projects with a national scope: development of the EPSDT General System Design for the Medicaid Management Information System (MMIS); development of the SURS Best Practices Guide, which was distributed to Medicaid fraud and abuse detection units nationally; assessment of MMIS systems nationally for Y2K readiness; and HIPAA technical assistance for Medicaid and Medicare.
Federal Substance Abuse and Mental Health Services Administration (SAMHSA) through which FOX is providing HIPAA technical assistance to state alcohol and drug programs nationally
Three-quarters of the state Medicaid agencies and multiple state mental health and public health departments
County healthcare, public health, and mental health departments in Arizona, California, Florida and Virginia

For FOX, consulting in the public sector is not a sideline - it is our primary business. Therefore, FOX brings a unique understanding of public sector concerns that differentiates us from our competitors. Our public sector experience allows us to tailor our consulting processes and tools to effectively assist public sector organizations, and our approach incorporates three factors essential for successful outcomes:

Factor One

We understand the public mandate for making good use of taxpayer dollars. FOX also is acutely aware that government agencies are in the business of trying to do more with less. While a need for services may expand, public budgets rarely follow suit, but our sensitivity to this accountability improves FOX's performance in two ways. First, we ensure that the programs and products we craft for our public sector clients are responsive to government accountability systems. Second, we adhere to internal control and monitoring systems to guarantee that each of our projects stays on time and on budget. Although private sector firms are also cognizant of their bottom lines, the decision to expend funds does not create the political issues that increasing budgets does for public sector agencies.

Factor Two

FOX recognizes that the public environment consists of diverse constituencies and multiple stakeholders. Therefore, the project work plans executed by FOX are designed to provide maximum opportunities for input from internal and external stakeholders. Our methods include the identification of internal and external customers, and the implementation of processes such as public hearings and focus groups that allow for these stakeholders to share ownership of the solutions. FOX understands that these activities are a fundamental part of public sector processes.

Factor Three

FOX understands how government programs operate and understands the interagency dependencies that exist. This helps us effectively manage the linkages between programs and agencies and between funding streams and program delivery. Our knowledge of government budgeting principles and politically charged environments ensures that our projects and recommendations remain grounded in the real world. We understand the relationship between agencies and any sister agencies involved with functions such as managed care, waiver administration, and government provider organizations, and how HIPAA and MMIS affect them all.