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MERCER GOVERNMENT

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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EVV Webinar

Are you ready for compliance?

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.

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New Leadership

Mercer GHSC has a new National Practice Leader

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.

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Alicia Smith

HMA Managing Principal Joins Mercer

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.

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Supporting Key Conferences

Mercer participates in and sponsors a number of health care conferences each year.
NASHP

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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HCBS

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

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 NEWSLETTER - FEBRUARY 2018

OUR TAKE ON CURRENT MEDICAID TRENDS

STAY CONNECTED If you'd like to be included on future communications, please contact us to join our exclusive distribution list. To view our full 2018 Newsletter, click here

This newsletter shares information you need to move your health programs forward. Here is a quick intro to a few of the key articles:

Medicaid and CHIP

Predictions for 2018

The beginning of 2018 looks to be a continuation of 2017’s trend of uncertainty when it comes to ACA, Medicaid and CHIP. To the surprise of many by the end of 2017...

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Biosimilars

Lower Cost Versions of Biologic Drugs

Most of us are familiar with the concept of generic drugs. Lower cost generic versions of drugs become available when the patent...

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Collaboration

A Holistic Care Approach

States are challenged with building high quality, cost-effective health care systems to meet the growing needs of individuals amidst...

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Harnessing Data

Transforming Data into Actionable Information

Like the rest of the world, healthcare has been bitten by the “big data” bug. States have greater access to more data than ever before...

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21st Century Cures Act

EVV...And Beyond

As we enter 2018 states are focusing on how they will comply with the electronic visit verification (EVV) requirements in the 21st Century...

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Mercer is Dedicated to Keeping States Informed

21st Century Cures Act

Signed into law on December 13, 2016, the Cures Act is designed to help accelerate medical product development and bring new innovations and advances to patients who need them faster and more efficiently.  Mercer is here to help.  Contact us at mercer.government@mercer.com for more information.

Potential Changes in Medicare Landscape

Mercer continues to monitor potential changes in the Medicare and Medicaid systems. We understand that States may have concerns and are uncertain about how these changes may impact their services. If you are interested in talking to a consultant about your State, please contact one of our office business leaders or your assigned client leader, or contact us with your questions and concerns via email.

Services

Overview

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

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Strategy

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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Financial

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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Substance Use Disorders

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.

 

Case Study


SITUATION

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.

CHALLENGE

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.

Read about the ACTION taken and the result

Update on the CHIP and the ACA Health Insurer Provider Fee

On January 22, 2018, Congress passed short-term funding legislation to end the government shutdown and authorize government spending through February 8, 2018. The law includes two provisions of interest to CHIP Programs.  Read more here or contact us via email.