Mathieu Doucet

Mathieu’s area of expertise is healthcare programs, including managed healthcare and Medicaid acute and long-term care populations.

Mathieu has worked with public programs across the nation for the majority of his career in a variety of capacities. He has worked with clients to:

• Develop managed care rates for physical health, behavioral health, PACE, home and community-based services, and non-emergency transportation programs
• Establish strategy around program design, rate negotiations, and contracting strategy
• Develop FFS rates for behavioral health and home- and community-based services
• Implement risk adjustment models for acute care and managed LTC Medicaid populations
• Implement risk mitigation strategies in new managed Medicaid programs
• Prepare analyses to respond to Medicaid MCO concerns regarding capitation rates
• Assist new and existing MCOs in evaluating state Medicaid rates by creating analogous rate ranges
• Attend state rate hearings on behalf of MCOs to better understand underlying capitation rate development assumptions
• Develop project Medicaid agency-wide budgets
• Evaluate the impact of the Affordable Care Act on state Medicaid programs
• Complete waiver-related cost effectiveness and other financial analyses
• Evaluate Medicaid managed care rates and provide negotiation support for Medicaid health plans and associations

He has assisted clients with provider capitation analyses, pricing, valuation of liabilities, product design, financial projections, financial reporting, and experience analysis. Mathieu has advised many organizations, including HMOs, insurance companies, Medicaid health plans, state agencies, employers, and healthcare providers.

He is experienced with reserve calculation, experience analysis through the use of databases and statistical programming, production of utilization benchmarks, and projection of commercial, Medicare, and Medicaid utilization and costs.

Mathieu’s prior experience, which included development of Medicare Advantage bids, allows him to provide additional insight to his clients in preparing responses to questions from current CMS reviewers.

Mathieu is fluent in French and English.