Michael’s area of expertise is managed healthcare programs, including Medicaid and Medicare Advantage (Parts A/B and D). He has advised state and federal government agencies, as well as private insurers.
Michael 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 and certify managed care rate ranges or upper payment limits for physical health, behavioral health, PACE, home and community-based services, foster care case management, 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.
- Develop project Medicaid agency-wide budgets.
- Complete waiver-related cost effectiveness and other financial analyses.
- Evaluate Medicaid managed care rates and provide negotiation support for Medicaid health plans and associations.
- Prepare Medicare Advantage Part A/B and Part D bids and respond to desk review and audit requests.
Michael advises a wide range of clients on public programs.
- Michael serves as the certifying actuary for programs in Minnesota and Wisconsin. He was previously the certifying actuary for six other states.
- He has assisted health plans in evaluating Medicaid managed care rates in several other states.
- Michael has advised the Medicare-Medicaid Coordination Office in rate development and structure for the Financial Alignment Initiative (a.k.a. “Dual” Demonstration).
