John has a diverse background in health insurance and managed healthcare programs. He has advised state government agencies, health systems, insurance companies, HMOs, and other healthcare clients. His experience with commercial, Medicare, and Medicaid coverage from the perspective of insurers, providers, and government stakeholders allows him to provide unique insight on a wide range of issues.
Public program consulting experience
John has extensive experience working with public healthcare programs and is recognized as a Medicaid industry expert. He currently serves as the state Medicaid agency's actuary in Florida, Mississippi, New Hampshire, and South Carolina. He works with his clients to:
Develop new Medicaid managed care programs
Develop and certify Medicaid managed care rates and risk adjustment calculations
Provide financial oversight of Medicaid managed care organizations
Evaluate the impact of PPACA on state Medicaid programs, including detailed analysis of the 2014 expansion population
Develop Medicaid budget projections and financial analysis of new initiatives
Evaluate Medicaid managed care rates and provide negotiation support for Medicaid health plans and provider organizations
Analyze the feasibility of starting a provider-owned Medicaid MCO
Assess the feasibility of participating in CMS dual eligible integration opportunities
Health system consulting experience
John works with health systems to analyze the financial risk of alternative contracting arrangements and provide other analytical support. He works with his clients to:
Review proposed contract language and support payer negotiations
Evaluate alternate contracting opportunities for the commercial and Medicare Advantage populations, including shared savings arrangements, capitation, quality incentive programs, bundled payments, and other structures
Identify and model alternate contracting arrangements with state Medicaid agencies and Medicaid MCOs, including direct contracting opportunities, accountable care organization structures, and capitation arrangements
Analyze the feasibility of starting a provider-owned health plan
Evaluate the impact of PPACA on health systems
Provide utilization and volume benchmarks for budgeting and planning
Professional Designations
Fellow, Society Actuaries
Member, American Academy of Actuaries
Education
BBA, Actuarial Science, Risk Management, and Quantitative Analysis, University of Wisconsin
Affiliations
Member, American Academy of Actuaries Medicaid Workgroup
28 November 2023 - by Josh Collins, John D. Meerschaert, Ong Xie
In this article for the Society of Actuaries, we review Milliman's partnership with the United Nations Development Programme to grow global actuarial capacity and support sustainable economic development.
06 February 2018 - by Shelly S. Brandel, John D. Meerschaert
This report identifies practical strategies that states can deploy to support Medicaid managed care plans and their network providers in addressing social issues.
31 January 2012 - by Mathieu Doucet, John D. Meerschaert
An analysis of the impact of the health insurer fee introduced in the Patient Protection and Affordable Care Act (PPACA) on state Medicaid programs and Medicaid health plans.
