HELPING GOVERNMENTS SHAPE TOMORROW'S HEALTH PROGRAMS Mercer Government Human Services Consulting (GHSC) has been partnering with states and other stakeholder organizations for over 30 years to support health care programs for the low-income and most vulnerable populations in this country.
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Mercer recently held a webinar on the challenges states face building high quality, cost-effective health care systems to meet the growing needs of individuals. The last MFP grants were awarded in 2016, enrollment of new participants will end by 2018, and claiming for those community transitions will be complete in 2020. With the end of the program at hand, states are now facing questions regarding the future of transition activities in a post-MFP world and how they will sustain the progress made by their programs into the future. Listen to what Mercer consultants had to say about this all important topic.
We are pleased to announce Sam Espinosa as our new National Practice Leader. Sam has been with Mercer since 1997, most recently as the Phoenix Office Business Leader for GHSC. With 23 years of experience in the industry, Sam has an excellent record of providing integrated solutions and savings to state Medicaid programs. He is prepared to lead us as we help our government clients gain leverage, create economies of scale, and foster new innovations by connecting the dots between Medicaid, state employees, corrections, and other health purchasers.
Since joining Mercer in 2012, our own Dr. Laura has made significant contributions to GHSC, serving as our first (and only) GHSC physician/psychiatrist, leading many projects across multiple states, serving as client lead for South Carolina and Arizona’s Division of Developmental Disabilities, and functioning as a people manager. Dr Nelson will be replacing Denise Podeschi who is retiring after more than twenty years with Mercer.
The deadline for complying with the electronic visit verification requirements contained within the 21st Century Cures Act is rapidly approaching. We conducted this webinar on April 26 for state employees, providing information beyond the basics needed for compliance and will assist states across the continuum of compliance in the development and implementation of their EVV systems.
Joining Mercer provides an even greater opportunity for me to use my behavioral health experience and to hopefully provide a different perspective to colleagues and clients on projects. Oftentimes, our clients ask for help doing what is familiar. What I have learned is that every stakeholder has an important viewpoint to be understood, even if it is not always able to be accommodated. This is pretty exciting for me and not something that exists in every work environment.
STAY CONNECTED If you'd like to be included on future communications, please contact us to join our exclusive distribution list. This newsletter shares information you need to move your health programs forward. View the articles below:
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NASHP - National Academy for State Health Policy
This year's theme is "Shifting Tides in State Health Policy". Join us for this 31st Annual Conference from August 15-17 in Jacksonville, Florida.
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NASUAD - Nat'l Assoc of States United for Aging and Disabilities
Mercer is a proud sponsor of this year's HCBS conference to be held in Baltimore, Maryland from August 27-30.
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NAMD - National Association of Medicaid Directors
The Fall 2018 conference will take place from November 12-14 in Washington DC. Mercer attends this premier event every year.
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Mercer Government Human Services Consulting provides a full range of consulting services.
Rich in experience with strategic planning, interpretation and application of regulations and policy, managed care procurement, operations, waivers, financing, and rate setting.
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.
Mercer understands states must consider cost containment and program sustainability, network development and capacity needs and how to incentivize high-quality performance through effective procurement and contracting. States must consider how they will finance these services and understand the regulatory requirements of funding streams. Requirements related to the Mental Health Parity and Addiction Equity Act (MHPAEA) final rule, the Home and Community-Based Services (HCBS) final rule and the Medicaid Managed Care final rule all impact the design and implementation of a state’s SUD service system.
Mercer assists states in SUD program design, development of federal state plan amendments and CMS waivers, procurement activities, actuarial rate setting and analysis, managed care contracting, value-based purchasing, staff training and development, and conversion from fee-for-service to a managed care delivery system.
Prior to 2011, the state’s Medicaid program did not include SUD treatment services as a covered benefit. State general funds and/or federal block grant dollars were the primary source of funding to pay for SUD services to Medicaid-eligible members. In an effort to contain costs while also expanding access to SUD services for Medicaid-eligible members, the state decided to add SUD benefits to its Medicaid state plan and incorporate these benefits into its managed care structure.
The state wanted to expand coverage and capacity for an array of ASAM levels of care and support adoption of medication-assisted treatment. The state wanted to support providers and managed care organizations in this transition by helping them fully understand service definitions, provider qualifications and billing expectations. The state also recognized the need to gather current SUD program and staffing information from providers in order to assist in provider reimbursement and capitation rate development.
