California State University – Sacramento, BA, Sociology
Robert Ducay is a seasoned health care professional with 14 years of experience in policy, budget, legislation, and stakeholder engagement with specific expertise in Medicaid financing and reimbursement methodologies. Robert engages in direct client services providing research, advice, strategy, payment modeling, and expertise on market dynamics, state budget, federal and state requirements, and emerging policy practices particularly as it relates to California and its Medicaid program. He is based in our Austin practice.
Robert most recently served as Assistant Deputy Director of Health Care Financing at the California Department of Health Care Services (DHCS), a role where he helped oversee four divisions with approximately 200 staff: Capitated Rates Development, Safety Net Financing, Fee-for-Service Rates Development, and Local Governmental Financing. These divisions are charged with the design, development, implementation, administration, oversight and evaluation of all reimbursement policies as it relates to California’s Medicaid program. This includes managed care actuarial rate development, fee-for-service rate development, hospital financing, long term care rate setting, school and county based reimbursement, and behavioral health. Further, this includes such reimbursement mechanisms as directed payment methodologies, provider fees, diagnosis related groups, supplemental payments, certified public expenditures, intergovernmental transfers, shared savings, value based purchasing, and county realignment. Robert has an excellent understanding of California legislation, particularly the state budget process, as well as California’s Medicaid and the Health Benefits Exchange programs. Before joining DHCS, Robert worked at the California Health and Human Services Agency as Assistant Secretary for seven years, with program oversight over the Medicaid program and California Health Benefit Exchange. In this role he was involved in every major policy proposal and program change in California’s Medicaid and Exchange programs during that time, including but not limited to the Affordable Care Act implementation, including the Optional Adults Expansion, Managed Care Expansion, 1115 Waiver, and California’s Duals Demonstration and Coordinate Care Initiative. He also worked at the California Department of Finance working directly on the development, presentation, defense, and implementation of California’s annual budget.