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Luke B.G. Roth

Principal and Sr. Healthcare Consultant
Seattle, WA, US

Luke Roth is a principal and senior healthcare consultant in the Seattle office of Milliman. He rejoined the firm in 2018.

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Experience

Luke has over 15 years of experience providing strategic guidance and transformative solutions to healthcare leaders and policymakers as they navigate the unique risks and opportunities facing their organizations. His primary areas of expertise include:

  • Evaluation, design, and rate setting for hospital inpatient and outpatient prospective payment systems, including inpatient DRG-based payment systems, outpatient APC- and EAPG-based payment systems, bundled and episodic payments, and outcomes-based incentive payments.
  • Medicaid supplemental payments strategy, including evaluation, design, and implementation of 438.6(c) state-directed payments and FFS supplemental payments.
  • Medicaid program funding strategies, including development and implementation of health care-related taxes, intergovernmental transfer (IGT) programs, and certified public expenditure (CPE) programs.
Publications and Presentations
  • Author, "State-directed payment considerations for the CMS Medicaid and CHIP Managed Care Access, Finance, and Quality proposed rulemaking." Milliman White Paper. May 2023.
  • Author, “Addressing Nursing Facility Financing Challenges During MLTSS Program Development.” ADvancing States MLTSS Institute Report. April 2022.
  • Author, “Hospital care for the uninsured in the United States: An analysis of national data sources.” Milliman White Paper. February 2021.
  • Author, “Designing payment arrangements for Medicaid providers in response to the COVID-19 emergency.” Milliman White Paper. April 2020.
  • Author, “Approved Medicaid State Directed Payments: How States are Using §438.6(c) ‘Preprints’ to Respond to the Managed Care Final Rule.” White Paper. October 2018.
  • Member, “CMS Hospital Wide 30-Day All-Cause Unplanned Readmission Measure for Medicaid Beneficiaries.” Technical Expert Panel (TEP). March 2017 to September 2017.
  • Author, “Insights for Designing Effective Medicaid Readmissions Policies.” Issue Brief. February 2017.

Education

  • BA, Mathematics, University of Washington

Publications

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