Mercer Government

CMS Medicaid Managed Care Final Rule

FFS Access and HCBS

A review of CMS' latest Final Rule aimed at enhancing access to and transparency of Medicaid services, including HCBS. This rule pairs with two other final rules published in April 2024 that focus on improving Medicaid eligibility

https://www.mercer-government.mercer.com/our-insights/Managed-Care-Final-Rule-FFS-Access-and-HCBS.html

Access and Quality Requirements

A thorough review of the complex CMS Medicaid Managed Care Final Rule - Access and Quality Requirements. This review focuses on regulatory changes impacting quality and access-related topics.

https://www.mercer-government.mercer.com/our-insights/Managed-Care-Final-Rule-Access-and-Quality.html

Financial Requirements

A review of CMS' Final Rule focused on the financial topics affected by the Rule, including ILOS, SDPs, MLRs and comparative rate analyses. References to MCOs include Prepaid Inpatient Health Plans and Prepaid Ambulatory Health Plans.

https://www.mercer-government.mercer.com/content/mercer-sites/mercer-government/global/en/our-insights/Managed-Care-Final-Rule-Financial.html

Featured Insights

The CCBHC Demonstrations

Learn more about CCBHCs and how we can support states at all stages of CCBHC implementation.

https://author.www.marshinc.net/content/dam/mercer-subdomains/us-government/attachments/New/CCBHC-Demonstration_FS.pdf

Drug Trend and Pipeline Report

The complex pharmacy marketplace continues to evolve as new products are introduced and treatment paradigms are updated.

https://www.mercer-government.mercer.com/our-insights/2024_DrugTrendAndPipeline.html

Spotlight: 21st Century Leaders

This organization holds a week-long leadership development program "Healthcare & IT Institute" for high school students.

https://www.21stcenturyleaders.org/for-students/summer-leadership-institutes/healthcare-it-institute-hii/

Who we serve

Partnering with states

We share our experience and feedback from clients since 1985.

https://www.mercer-government.mercer.com/who-we-serve.html

Medicaid news and more

Our thought leadership

Insights and guidance on Medicaid news impacting the services and budgets you manage.

https://www.mercer-government.mercer.com/our-insights.html

Looking for top talent

Search our careers

Explore the opportunities - click the arrow, search for "government".

https://www.mercer.com/careers/mercer-careers/

We know experience matters

Mercer Government Employees

States Served

Years of Government Experience

Medicaid Dollars Managed

Lives Touched

Actuaries of Record

The landscape of government-sponsored health care programs is changing. Our assistance to state Medicaid agencies and beyond is built on our actuarial expertise and the creativity to develop comprehensive solutions.

What we do

The Mercer team came together and produced a solid, comprehensible model design.

- Director, Division of Health Services

A Medicaid Story

Medicaid serves almost 86 million Americans. Hear one woman's brave journey after a devastating disability and how Medicaid impacted that journey. A reminder of why we work to support states.

Watch the video

It’s been an honor to work alongside you all...very appreciative of your commitment to our programs.

- Executive Director, Health Care Finance

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Mercer Government Managing Medicaid Challenges Together