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An Interview with Michael R. Smith
An Interview with Dr. Laura K. Nelson, MD
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Recent Mercer Communications
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MERCER GOVERNMENT NEWSLETTER - JULY 2017
HELPING SUPPORT HEALTHCARE'S FOUNDATION DURING THIS TIME OF CHANGE
Mercer 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. We face an unprecedented environment of uncertainty and change in the Medicaid and CHIP programs, and yet, there is a need to keep moving forward. This newsletter shares information you need to move your health programs forward.
AFFORDABLE CARE ACT REPEAL AND REPLACE EFFORTS: UNCERTAIN TIMES
After a dramatic journey through the House and the Senate, Congressional efforts to repeal and replace the Affordable Care Act (ACA) are now stalled, with Medicaid a key focus of the Senate deliberations. At the time of the drafting of this article, Senate GOP leadership has announced plans to introduce a repeal and delay bill to repeal ACA but provide Congress...
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Medicaid/CHIP Parity Compliance
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Medical Loss Ratio: Not as Bad as it Seems
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Management of Specialty Drug Trend
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How will you maximize your Medicaid dollar while increasing access and quality in an uncertain healthcare environment?
States with Medicaid managed care organizations, alternative benefit plans, and separate CHIP programs are...
Quality encounter data can seem like an elusive unicorn in the health care world. However, having complete, accurate...
New medical loss ratio requirements play a prominent role in the Centers for Medicare and Medicaid Services...
Specialty drugs are generally considered to be high cost drugs that are used to treat complex, chronic, or rare medical...MERCER GOVERNMENT FLASH NEWS - FDA APPROVES MAVYRET
On August 3rd, the Food and Drug Administration (FDA) approved Mavyret™ (mav-EH'-rit), a new product manufactured by Abbvie for the treatment of hepatitis C virus (HCV). Mavyret™ is approved for the treatment of all six major HCV genotypes for both treatment naïve and treatment experienced patients. Mavyret™ is a combination of two new HCV antivirals, glecaprevir and pibrentasvir. An estimated 95% of patients with chronic hepatitis C in the U.S. could be candidates for treatment with Mavyret™. The list price of Mavyret™ is significantly lower than the list price for other HCV antiviral regimens.
Mavyret™ is a game changer in the Hepatitis C market. Its approval for a short 8-week regimen for treatment naïve patients across all genotypes coupled with a list price that is less than half of the competition will position it well for preferred placement on Medicaid fee-for-service (FFS) and managed care formularies. Abbvie representatives have stated publicly that they are focusing on getting coverage approved through the Medicaid, Medicare, and Veterans Administration markets.
Read more about Indication and Use, Place in Therapy, and Cost
We are on the Road Again!
NASUAD HCBS CONFERENCE
Mercer will be leading two workshops: Realizing the Value of VBP and another on MLTSS Program Design and Implementation.
View the Details
HSFO Annual Conference
70th Annual National Association of State Human Services Finance Officers will be held in New Orleans this year. Mercer will be presenting.
More information
NASHP Annual Conference
Mercer will facilitate a roundtable at the National Academy for State Health Policy conference on Medicaid and SUD.
View the Details
The AAA Health Practice Council Weighs in on the AHCA
Mercer contributes to the American Academy of Actuaries' letter on AHCA to House Speaker Ryan and House Democratic Leader Pelosi
A collaborative effort by individuals on the AAA Individual and Small Group Markets Committee, the Medicaid Subcommittee, along with Mercer staff. View the letter here
Services
Overview
Mercer Government Human Services Consulting provides a full range of consulting services.
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.
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.
Impact of the New Administration on Medicaid
Mercer's Dedication to Keeping our Clients Informed
The outcomes of last month’s elections will certainly result in changes to the rules that govern/impact the health care system as a whole, including the Medicaid program. Although the details of those changes remain uncertain today, we want to assure our clients that we are actively exploring the possible changes that lie ahead and building the tools and resources our clients will need to assess these new policy directions. In the next few weeks and throughout the transition period post-inaguration, we will provide informational resources and updates. In the meantime, please contact us with your questions and concerns via email.
Mercer Contributes to NGA's Medicaid Compendium
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."
Read more information
Section II - Federal Authorities and Compliance
Employees contributing to Compendium Section II include Leena Hiilivirta, Bill Lasowski and Stephanie Kurlanzik
View this section
Section V - Financial Models
Including rate setting, risk adjustment, performance indicators. Contributors were Fred Gibison, Kevin Lurito, Gabe Smith, Doug Shannon, Amanda Rhodes
View Section V
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.
DID YOU KNOW?
Mercer Government includes more than 15 former state and federal health care leaders and:
290+ Staff - 27 ASAs - 20 FSAs - 5 CPAs - 9 Clinicians - 6 Pharmacists
