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Our projects support the evolution of coordinated care programs that improve the quality of life and lower expenditures for high-need Medicaid and Medicare beneficiaries.

What We Do

Business Development Strategy and Proposal Support
Data Analytics and Products
Operational Support for Managed Care Optimization
Public Policy Analyses

Business Development Strategy and Proposal Support

The Menges Group helps our clients win state Medicaid procurements, meaning we help our clients exist. We assist with several procurements annually, and the majority of our clients not only earn a contract award, they score first or second.

Learn More About This Service

Our Team

Joel Menges

Chief Executive Officer

Amira Mouna

Founding Partner

Poornima Singh

Founding Partner

Jessica Wiecezak

Founding Partner

Grace Bernstein

Director

Michelle Gogerty

Director

Taryn Nader

Director

Veronica Sever

Director

Charles Townley

Director

Christie Ahn

Managing Consultant

Emalee Barto

Managing Consultant

Manisha Gupta

Managing Consultant

Kyra Henderson

Managing Consultant

Hannah Jin

Senior Consultant

Clarissa Moore

Senior Consultant

Courtney Pfeifer

Senior Consultant

Madeline Walters

Senior Consultant

Mint Dalton

Consultant

Grace Hong

Consultant

Anastasia Johnson

Consultant

Haley Quinn

Consultant

Danielle Shapero

Consultant

Phyllis Call

Office Administrator

Erin Gaul

Summer Intern

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5-Slide Series

Optimizing Medicaid MCO Procurements

This edition focuses on Medicaid MCO procurements, an area where our company conducts vast project work. We describe a few actions states can take to get the most value out of their procurements. We also offer some thoughts regarding how states can better overcome a protest process…

Read more Volume 125

5 Slide Mini-Series Edition #6: Bibliography of Suicide and Homicide Gun Death Analyses

This final edition of our summer series on Suicides, Homicides, and Gun Deaths provides weblinks to roughly 20 examples of other organizations’ work in the same topic areas.

Read more Volume 6

5 Slide Mini-Series Edition #5: Guns in the Household- Family Choice Dynamics

This edition focuses on the choices all households make regarding having a gun in their home (or not). The statistical evidence is profoundly in favor of households making a “no gun here” decision, and some of that evidence is summarized herein. However, this objective evidence is at odds with…

Read more Volume 5

5 Slide Mini-Series Edition #4: Suicide and Homicide Rates by Race/Ethnicity, Gender, and Age

This edition quantifies death rates, and firearm death rates, by race/ethnicity, gender, and age.

Read more Volume 4

5 Slide Mini-Series Edition #3: Homicide Deaths in Relation to Household Gun Ownership Rates

This edition of our Gun Death Series focuses on homicides. Similar to suicides, the degree to which guns exist in a community are strongly correlated with the rate of homicide deaths. The states with the highest proportion of household gun ownership have a 78% higher rate of…

Read more Volume 3

5 Slide Mini-Series Edition #2: Gun Violence – Suicide Analyses

This edition continues our summer series on gun deaths, focusing on suicides. Suicide rates vary considerably by state, and these slides demonstrate that the variation across states is very highly correlated with household gun ownership rates. The firearm suicide rate in the cohort of states with the highest gun ownership was…

Read more Volume 2

5 Slide Mini-Series Edition #1: Suicides, Homicides, and Firearm Deaths

This is the first edition of a new prong of our 5 Slide Series focusing on household gun ownership and its role in suicide and homicide deaths.

Read more Volume 1

Medicaid MCO NCQA Accreditation Tabulations: Rating Year 2022-2023

This 5 Slide Series edition provides our tabulations and analysis of NCQA’s Quality Ratings for Medicaid MCOs juxtaposed with the specialized accreditations NCQA has awarded to these health plans.

Read more Volume 124

Medicaid MCO Quality Tabulations: NCQA Rating Year 2022-2023

This 5 Slide Series edition provides our tabulations and analysis of the NCQA Quality Ratings for Medicaid MCOs (Rating Year 2022-2023).

Read more Volume 123

Medicaid MCO Innovations to Address the Opioid Epidemic

This edition provides excerpts of opioid-related questions that have appeared in Medicaid MCO procurements. These slides demonstrate some of the ways in which states are using their request for proposal (RFP) process to promote innovation and elevate the MCOs’ mechanisms to effectively serve enrollees who have opioid use…

Read more Volume 122

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Recent Publications

Assessment of Washington State’s Medicaid Prescription Drug Management Performance and Policy Options

This report explores which prescription drug model is best suited for Washington’s Apple Health (Medicaid) program: the current carve-in prescription drug model, under which managed care organizations (MCOs) pay for members’ prescriptions, or a carve out model, where prescriptions are managed by a separate company using a fee-for service…

Keywords: Expenditures, Medicaid, Pharmacy Carve Out, Prescription Drugs

Costs and Benefits of Enhancing Private Duty/Shift Nursing Payment Rates in Pennsylvania’s Medicaid Program

This report was enlisted by the Pennsylvania Homecare Association to evaluate the need for enhancing Pennsylvania’s Medicaid Private Duty Nursing (PDN) payment rates. Through a mixture of quantitative analyses and real-life patient examples, this report highlights the anticipated benefits this PDN rate increase is projected to yield.

Keywords: Expenditures, Medicaid, Policy

Costs and Benefits of Enhancing Private Duty Nursing Payment Rates in Colorado’s Medicaid Program

This report was commissioned by the Home Care and Hospice Association of Colorado. The report derives the Medicaid payment rate increase needed to attract adequate private duty nursing (PDN) service capacity in Colorado. We’ve estimated the cost to the Medicaid agency these rate increases will create –…

Keywords: Expenditures, Medicaid, Policy

Trends in Opioid and Medication-Assisted Treatment Prescription Drug Usage in Medicaid

This report describes trends in opioid and medication-assisted treatment (MAT) prescription drug usage in Medicaid, put together for a presentation at a recent opioid conference.

Keywords: Medicaid, Prescription Drugs

Medicaid Prescription Drug Management: Quality Scores Compared Across Different Approaches

The Elevance Health Public Policy Institute engaged and worked with us to assess the degree to which quality scores on pharmacy-related measures were affected by the state’s Medicaid managed care program design features. The key issue assessed was whether quality scores were better in states where the prescription…

Keywords: Pharmacy Carve Out, Policy, Quality

Medication Adherence in Medicaid

Building upon our 2014 report titled Prescription Drug Adherence in Medicaid Managed Care, this report provides updated analyses performed on medication adherence, assesses the impacts of Medicaid expansion and the COVID-19 pandemic on medication adherence, and offers recommendations for further improvement to Medicaid medication access and adherence.

Keywords: COVID-19, Medicaid, Policy, Prescription Drugs

Medicaid Prescription Drug Benefit Management: Performance Comparison Across Different State Policy Approaches

States that employ Medicaid managed care organizations (MCOs) to pay for prescription drugs outperform states that rely on the fee-for-service (FFS) setting to control drug costs. Despite larger rebates in FFS, MCOs’ effective strategies to encourage…

Keywords: Expenditures, Medicaid, Prescription Drugs

Assessment of Kentucky’s Medicaid Managed Care Program Impacts

The purpose of this study is to assess the impacts of Kentucky’s Medicaid managed care program. The key components of this assessment include: • Cost impacts of the Medicaid managed care program across the past two decades • Performance on key quality measures • Opioid and medication-assisted treatment (MAT) prescription drug usage trends • Kentucky’s recent experience…

Keywords: Medicaid, Policy

Assessment of Medicaid Expansion Impacts

The purpose of this study is to compare the US states that have adopted the Affordable Care Act’s (ACA) Medicaid Expansion to the states that have not done so. The Medicaid Expansion makes people with incomes up to 138 percent of the federal poverty (FPL) line eligible for Medicaid….

Keywords: Expansion, Medicaid

Assessment of New Jersey’s Medicaid Prescription Drug Management Performance and Policy Options

The New Jersey Association of Health Plans enlisted the Menges Group to evaluate New Jersey’s Medicaid prescription drug costs and assess the potential impacts of a pharmacy carve-out approach, whereby the prescription drug benefit would be removed from the MCOs’ responsibility and paid for in the fee-for-service (FFS) setting….

Keywords: Pharmacy Carve Out, Policy, Prescription Drugs

Assessment of Washington State’s Medicaid Prescription Drug Management Performance and Policy Options

This report explores which prescription drug model is best suited for Washington’s Apple Health (Medicaid) program: the current carve-in prescription drug model, under which managed care organizations (MCOs) pay for members’ prescriptions, or a carve out model, where prescriptions are managed by a separate company using a fee-for service…

Keywords: Expenditures, Medicaid, Pharmacy Carve Out, Prescription Drugs

Costs and Benefits of Enhancing Private Duty/Shift Nursing Payment Rates in Pennsylvania’s Medicaid Program

This report was enlisted by the Pennsylvania Homecare Association to evaluate the need for enhancing Pennsylvania’s Medicaid Private Duty Nursing (PDN) payment rates. Through a mixture of quantitative analyses and real-life patient examples, this report highlights the anticipated benefits this PDN rate increase is projected to yield.

Keywords: Expenditures, Medicaid, Policy

Costs and Benefits of Enhancing Private Duty Nursing Payment Rates in Colorado’s Medicaid Program

This report was commissioned by the Home Care and Hospice Association of Colorado. The report derives the Medicaid payment rate increase needed to attract adequate private duty nursing (PDN) service capacity in Colorado. We’ve estimated the cost to the Medicaid agency these rate increases will create –…

Keywords: Expenditures, Medicaid, Policy

Trends in Opioid and Medication-Assisted Treatment Prescription Drug Usage in Medicaid

This report describes trends in opioid and medication-assisted treatment (MAT) prescription drug usage in Medicaid, put together for a presentation at a recent opioid conference.

Keywords: Medicaid, Prescription Drugs

Medicaid Prescription Drug Management: Quality Scores Compared Across Different Approaches

The Elevance Health Public Policy Institute engaged and worked with us to assess the degree to which quality scores on pharmacy-related measures were affected by the state’s Medicaid managed care program design features. The key issue assessed was whether quality scores were better in states where the prescription…

Keywords: Pharmacy Carve Out, Policy, Quality

Medication Adherence in Medicaid

Building upon our 2014 report titled Prescription Drug Adherence in Medicaid Managed Care, this report provides updated analyses performed on medication adherence, assesses the impacts of Medicaid expansion and the COVID-19 pandemic on medication adherence, and offers recommendations for further improvement to Medicaid medication access and adherence.

Keywords: COVID-19, Medicaid, Policy, Prescription Drugs

Medicaid Prescription Drug Benefit Management: Performance Comparison Across Different State Policy Approaches

States that employ Medicaid managed care organizations (MCOs) to pay for prescription drugs outperform states that rely on the fee-for-service (FFS) setting to control drug costs. Despite larger rebates in FFS, MCOs’ effective strategies to encourage…

Keywords: Expenditures, Medicaid, Prescription Drugs

Assessment of Kentucky’s Medicaid Managed Care Program Impacts

The purpose of this study is to assess the impacts of Kentucky’s Medicaid managed care program. The key components of this assessment include: • Cost impacts of the Medicaid managed care program across the past two decades • Performance on key quality measures • Opioid and medication-assisted treatment (MAT) prescription drug usage trends • Kentucky’s recent experience…

Keywords: Medicaid, Policy

Assessment of Medicaid Expansion Impacts

The purpose of this study is to compare the US states that have adopted the Affordable Care Act’s (ACA) Medicaid Expansion to the states that have not done so. The Medicaid Expansion makes people with incomes up to 138 percent of the federal poverty (FPL) line eligible for Medicaid….

Keywords: Expansion, Medicaid

Assessment of New Jersey’s Medicaid Prescription Drug Management Performance and Policy Options

The New Jersey Association of Health Plans enlisted the Menges Group to evaluate New Jersey’s Medicaid prescription drug costs and assess the potential impacts of a pharmacy carve-out approach, whereby the prescription drug benefit would be removed from the MCOs’ responsibility and paid for in the fee-for-service (FFS) setting….

Keywords: Pharmacy Carve Out, Policy, Prescription Drugs

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