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Public Policy Analyses

Overview

The Menges Group is regularly enlisted by health plan associations, provider associations, and other clients to conduct policy analyses and prepare reports that promote an evidence-based approach to health care policymaking. Our approach to unbiased public policy analyses includes extensive data analysis using publicly available or client-provided data. This is combined with qualitative analyses to further contextualize quantitative findings and identify programmatic impacts. Analyses may be national, state-specific, or focused on a specific target population.

Using these analyses, our team creates reports and conducts presentations to summarize the findings of our analyses and prepare our clients to meet with policymakers or other stakeholders. We may also meet directly with policymakers to present our findings.

Examples of Project Work

Many examples of our policy-focused project work are available on the Publications page of this website.  A few of our projects which have had a significant impact on Medicaid policy are briefly summarized below:

  • For a legislative committee in Alaska, we assessed the pros and cons of adopting Medicaid expansion. Our findings and recommendations played a role in the State’s decision to implement Medicaid expansion.
  • For North Carolina’s Medicaid agency we assessed design options for their Medicaid program to a managed care contracting model.
  • For a behavioral health entity in North Carolina, we created the design framework for a comprehensive care coordination program for persons with serious mental illness. This framework has evolved into the Tailored Plan program, which is now in the process of implementation.
  • In several states and on a nationwide basis, we have analyzed the value their Medicaid capitation contracting programs are yielding. Our access, quality, and cost findings help preserve and expand the use of comprehensive, highly integrated systems of coverage.
  • We often analyze the impact of Medicaid prescription drug policy alternatives, such as carve-in/carve-out decisions and whether or not states are best served by adopting a uniform preferred drug list (PDL).
  • We regularly produce our own analyses unrelated to our client work, including more than 140 editions of our 5 Slide Series (all of which are available on this website) and our 2021 assessment of Medicaid expansion’s costs, coverage impacts, employment impacts, and hospital revenue impacts.

Publications

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...
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Quantifying the Impact of State-Level Policy Changes on Opioid Prescription (and Unit) Volume ​

This edition looks at various state-level policy changes seeking to restrict inappropriate use of opioids, conducting a pre-versus-post comparison of prescription opioid usage related to the dates of these policy changes.
Read more Volume 121

Medicaid Postpartum Coverage Extension: A Review of Coverage by State and Postpartum Healthcare Utilization

This edition looks at state implementation of Medicaid postpartum coverage extension and Medicaid expansion by state. We also present rates of postpartum care utilization in the Medicaid population before and after implementation of postpartum coverage extension. As of March 2023, 45 states and D.C. have implemented Medicaid expansion...
Read more Volume 114

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.
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Assessment of Medicaid Reform Options Prepared for Alaska Legislative Budget and Audit Committee

The Legislative Budget and Audit Committee of Alaska sought information and analyses with regard to other states’ experiences with Medicaid reform and expansion initiatives. This report describes opportunities for Medicaid savings and to reduce pharmacy costs. As well as recommendations for contracting, incorporating employment supports, improving and monitoring access to...
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State Policies Regarding Medicaid MCO Preferred Drug Lists

The Association for Community Affiliated Plans (ACAP) enlisted The Menges Group to prepare a report on the ways in which state Medicaid agencies have opted to regulate Medicaid MCO PDL content. Most states afford MCOs wide latitude in establishing their PDLs. Conversely, a few states require MCOs...
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