Ed’s expertise is in group healthcare, with an emphasis on government-sponsored programs (including Medicare and VHA), and health care payer/provider relations. His experience covers a broad spectrum, including providers, payers, and purchasers. His consulting assignments have included:
Evaluating and comparing provider contracts, including development of the Hospital Evaluation and Comparison System (HECS) and GlobalRVUs, which are Medicare-based contract comparison tools
Developing and reviewing alternative provider payment arrangements, supporting both providers and payers
Developing Reasonable and Customary Charge Models
Comparing provider reimbursements for contract parity analyses
Conducting Medicare Advantage bid support for both Part C and Part D
Estimating financial impacts of regulatory and policy changes
Projecting liabilities for claims incurred but not paid
Preparing and certifying annual actuarial opinions
Developing and implementing risk adjustment algorithms and relative morbidity analyses
Projecting contribution rates for Multiple Employer Welfare Arrangements
In addition to his experience in healthcare, Ed also has extensive employee benefits experience with both Milliman and other consulting firms.
Professional Designations
Fellow, Society of Actuaries
Member, American Academy of Actuaries
Education
BA, Mathematics, Actuarial Science, University of Waterloo, Waterloo, Ontario
05 March 2021 - by Alison Counihan, Edward Jhu, Lalit Baveja
This paper considers the role of reimbursement mechanisms, and particularly diagnosis-related groups price adjustors, in directing general policy and specifically in the role of value-based healthcare.
Over the last several years, there has been an increased awareness by hospital and health system leadership teams of the importance of a thorough post-acute care (PAC) integration strategy, but far too few instances of these strategies being developed and executed.
04 April 2016 - by Will Fox, Edward Jhu, Charlie Mills
The Milliman RBRVS for Hospitals™ Fee Schedule provides a simple solution for comparing hospital contractual allowed amounts, billed charge master levels, relative efficiency, and patient mix differences with the fee schedule based on Relative Value Units (RVUs).
