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Talent. Health. Retirement. Investments

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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MFP Webinar

Listen to the recording

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.

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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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New CBHS Lead

Dr. Laura Nelson to replace retiring Denise Podeschi

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.

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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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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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MERCER GOVERNMENT NEWSLETTER - JULY 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. This newsletter shares information you need to move your health programs forward. View the articles below:

Opioid Epidemic

The Effect on the LTSS Population

Another day…another article on the nation’s opioid epidemic. Sadly, we continue to be inundated on a daily basis with articles about more overdose deaths, declarations...

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Hemlibra

Game Changer for Treatment of Hemophilia

For the first time in nearly 20 years, a new hemophilia A treatment is available that carries with it the potential to be both a clinical...

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Post-MFP

A Post-Money Follows the Person World

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

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The Tax Act

Underwriting Gain Assumptions and the New Corporate Tax Rate Impact

The Tax Cuts and Jobs Act reduced the federal corporate income tax rate on 2018 income...

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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 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.