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Talent. Health. Retirement. Investments

Mercer's Focused Review of the Managed Care Final Rule

We will be conducting a webinar on this rule that will focus on quality, access and network adequacy and MLTSS. This webinar will be held on Thursday August 18, 1-2:30pm Eastern.  Watch for the Invite!


A Mercer Webinar: Medicaid Managed Care Final Rule

View the Recording!

Many of you joined Mercer for this webinar on May 17, 2016 as we shared our initial reaction to the rule. States provided feedback and asked questions about the first major update to Medicaid managed care regulations since 2002 by CMS.

We discussed the new standards for rate setting and actuarial certification, the Medicaid medical loss ratio, limitations on provider payments and next steps.


A Mercer Webinar: Medicaid and Substance Use Disorders

The Key Strategies and Partnerships for Success

This Mercer Webinar was held on March 22, 2016 and provided the latest strategies and essential recommendations to help state Medicaid programs best meet the growing demands for treatment of substance use disorders (SUDs).

  • An update on best and promising clinical practices for the treatment of SUDs, including medication-assisted treatment
  • Implementation of medication-assisted treatement, physician-administered drugs, pharmacy rebates and interaction with the new pharmacy rule
  • Options for designing and funding a Medicaid SUD program that ensures affordability, cost containment/effectiveness, and sustainability
  • Key considerations for successful implementation of planned enhancements to the Medicaid SUD program.


Mercer Contributes to NGA's Medicaid Compendium

Released on January 11, 2016, NGA's Medicaid Health Care Purchasing Compendium is "intended to serve as a reference guide for states when purchasing health care services for their Medicaid program..."
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The NGA Compendium

"States face the ongoing challenge of managing the costs of their Medicaid programs while ensuring beneficiaries have access to quality health care."

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Section II - Federal Authorities and Compliance

Employees contributing to Compendium Section II include Leena Hiilivirta, Bill Lasowski and Stephanie Kurlanzik

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Section V - Financial Models

Including rate setting, risk adjustment, performance indicators. Contributors were Fred Gibison, Kevin Lurito, Gabe Smith, Doug Shannon, Amanda Rhodes

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Guidance for States on Prescription Drug Abuse

NAMD Publishes Mercer Study on Prevention of Abuse and Overdose of Prescription Drugs

Mercer developed the report for the National Association of Medicaid Directors providing guidance to reduce prescription drug abuse and overdose risks.  It discusses the epidemic and the effect on Medicaid recipients and provides recommendations to help states.

 Access the report

Industry Hot Topics

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States driven to rethink HCBS

With the 2014 release of the final HCBS federal regulations comes enhanced quality and added protections for recipients, but also new requirements and challenges.

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Prescription drug abuse epidemic

The CDC has recognized prescription drug abuse as a growing national epidemic. Prescription drugs are now the second-most abused category of drugs after marijuana.

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Medicaid integrity best practices

The US GAO issued a report calling for increased oversight of Medicaid program integrity efforts.

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New Mercer Solutions

An overview of our experience assisting government with their Medicaid and Medicare programs.

Our passion is to work as a team with our clients to help those in need throughout the country.


  Download overview



Mercer Government Human Services Consulting provides a full range of consulting services.

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Policy and Operations

Rich in experience with strategic planning, interpretation and application of regulations and policy, managed care procurement, operations, waivers, financing, and rate setting.

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Actuarial and Financial

Mercer is well positioned to assist clients on a variety of topics ranging from traditional capitated rate setting to program development and compliance with these new health care delivery models.

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