Mercer Short Duration Fixed Income Fund Class Y-3 · NASDAQ:MSDYX
Mercer Short Duration Fixed Income Fund Class Y-3 — Mercer Government — Investor Presentation (August 2023)
23 slides from Mercer Short Duration Fixed Income Fund Class Y-3's investor presentation, Aug 8, 2023
Slide 1: Directed Payments Under Managed Care
welcome to brighter Directed Payments Under Managed Care August 8, 2023 A business of Marsh McLennan
Slide 2: Directed Payments Timeline
Directed Payments Timeline Medicaid Managed Care, CHIP Delivered in The Use of New or Managed Care, and Increased Pass-Through Revisions Related to Payments in Medicaid Third Party Liability; Managed Care Delivery Final Rule Systems; Final Rule May 6, July 29, January November 2, 2016 2016 18, 2017
Slide 3: Directed Payments Timeline
Directed Payments Timeline 2020-2021 Medicaid Managed Care Rate Development Guide For Rating Periods Revised Pre-Print Starting between Form and Pre-Print July 1, 2020, and Addendum June 30, 2021 Released July 2, January December 2020 8, 2021 20, 2022 State Medicaid Medicaid and Director Letter # 21
Slide 4: Types of Directed Payments: Uniform Rate Increase
Types of Directed Payments • 42 CFR §438.6(c)(1)(iii)(C) • Requires Managed Care Organizations to pay a uniform amount or percentage above the MCOs negotiated rates. • Most common form of directed payments. Uniform Rate • Equivalent to supplemental payments under Fee for Service. Increase • Oregon:
Slide 5: Types of Directed Payments: Minimum or Maximum Fee Schedule
Types of Directed Payments • 42 CFR §438.6(c)(1)(iii)(A), 42 CFR §438.6(c)(1)(iii)(B) or 42 CFR §438.6(c)(1)(iii)(D). • State Medicaid Agency sets a floor or ceiling for the base payments that an MCO can pay a Minimum or provider for services. Maximum Fee • Most common is that MCOs pay no less than
Slide 6: Types of Directed Payments: Value-Based Payments
Types of Directed Payments • 42 CFR §438.6(c)(1)(i) or 42 CFR §438.6(c)(1)(ii) • Requires Managed Care Organizations to pay to implement VBP Model • Pay-for-Performance • Shared Savings Arrangements Value-Based • Models that require participation in multi-payer or Medicaid-specific delivery system r
Slide 7: State Direct Payment Types and Projected Payment Amounts
State Direct Payment Types and Projected Payment Amounts Table obtained from MACPAC June 2023 Issue Brief “Directed Payments in Medicaid Managed Care”. Table based on information obtained from CMS approved SDPs from July 1, 2021, to February 1, 2023.
Slide 8: Requirements of State Directed Payments: Date and Timing Information
Requirements of State Directed Payments Required Date and Timing May 3, 2023 Proposed Rule Information Additions • Managed Care Contract Rating Period • Propose to require that all SDPs requiring written prior approval from • Requested Start Date CMS must be submitted to CMS no later • Duration for
Slide 9: Requirements of State Directed Payments: Incorporation Into Managed Care Contracts
Requirements of State Directed Payments Incorporation Into Managed Care Contracts Current Requirements May 3, 2023 – Proposed Rule Changes Contract arrangements that direct the Require MCO contracts to detail SDP dates, managed care plan’s expenditures must amounts, fees, procedure codes, provider h
Slide 10: Requirements of State Directed Payments: Value Based Payments
Requirements of State Directed Payments State must identify the class or classes of providers that will participate in the payment arrangement. State must describe how the payment arrangement intends to recognize value of outcome over volume of services. Value Based State must identify the measure(s
Slide 11: Requirements of State Directed Payments: Proposed Rule Changes
Requirements of State Directed Payments Value Based Proposes to remove the existing requirements at §438.6(c)(2)(iii)(D) that currently Payments (VBP)/ prohibit States from recouping unspent funds allocated for these SDPs. Delivery Reform System (DRS) Remove the existing requirements that currently
Slide 12: State Directed Fee Schedules
Current Preprint Requirements of State Directed Payments State Directed Fee Schedules Determine Type of Identify Basis for Requirements for Uniform Dollar or Fee Schedule Fee Schedule Maximum Fee Percentage Increase SDP SDP Schedule Questions Approved State State assures that MCOs Uniform Dollar Amo
Slide 13: State Directed Fee Schedules: Proposed Rule
Preprint Requirements of State Directed Payments State Directed Fee Schedules May 3, 2023 Proposed May 3, 2023 Proposed Rule – May 3, 2023 Proposed Rule – Average Pre-Print Exclusion Rule – Reconciliations Commercial Rate No interim payments Allow total SDP payments to based on historical Allow Stat
Slide 14: Provider Class and Assessment of Reasonableness
Requirements of State Directed Payments Provider Class and Assessment of Reasonableness Identify the class or classes Describe how the How will the SDP For payment arrangements that are of providers that will payment arrangement interact with intended to require plans to make a participate in this p
Slide 15: Incorporation Into the Actuarial Certification
Requirements of State Directed Payments Incorporation Into the Actuarial Certification • Identify using the table for each actuarial rate certification review that includes state directed payments. • If state-directed payment not included in actuarial rate certifications, the State must provide Subm
Slide 16: Incorporation Into the Actuarial Certification
Requirements of State Directed Payments Incorporation Into the Actuarial Certification In accordance with 42 CFR. §438.6(c)(2)(i), States assure that all expenditures for this SDP are developed in accordance with 42 CFR §438.4, the standards specified in 42 CFR §438.5, and generally accepted actuari
Slide 17: Incorporation Into the Actuarial Certification: Proposed Rule
Requirements of State Directed Payments Incorporation Into the Actuarial Certification May 3, 2023 Proposed Rule • Require States to submit a rate certification or rate certification amendment incorporating the separate payment term within 120 days of either the start of the payment arrangement or w
Slide 18: Intergovernmental Transfer and Provider Tax/Assessments
Requirements of State Directed Payments Intergovernmental Transfer Provider Tax/Assessments • State must provide information on the following: name of • Provide a table with the following: Name of the Health Care entities transferring funds, operational nature of the transferring Related Provider Ta
Slide 19: Funding of Non-Federal Share
Requirements of State Directed Payments Funding of Non-Federal Share Non-Federal share of SDP May 3, 2023 Proposed Rule Changes arrangements must comply with Federal regulations. States would be required to ensure that each participating provider in an SDP arrangement attests that it does not partic
Slide 20: Quality Criteria and Framework for All Payment Arrangements
Requirements of State Directed Payments Quality Criteria and Framework for All Payment Arrangements Goals and State Quality Every Three Strategies > Revisions Years Objectives Medicaid Assure that SDP to advance States must post the final States must submit draft To be in compliance. with 42 at leas
Slide 21: Quality Criteria: May 3, 2023 Proposed Rule Changes
Requirements of State Directed Payments Quality Criteria and Framework for All Payment Arrangements May 3, 2023 Proposed Rule Changes Evaluation plan must identify at Propose to require that Require States to include least two metrics that CMS clarifies its evaluation reports baseline performance wo
Slide 22: Directed Payment Arrangement Denials: Proposed Rule
Requirements of State Directed Payments Incorporation into the Actuarial Certification May 3, 2023 Current State Proposed Rule Directed Payment Allows States to Arrangements Appeal Denials to Denials Cannot Be Health and Human Appealed Services (HHS) Department Appeals Board 22
Slide 23: A business of Marsh McLennan
Services provided by Mercer Health & Benefits LLC. A business of Marsh McLennan Copyright © 2021 Mercer Health & Benefits LLC. All rights reserved.
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