Philip Nelson

Phil’s areas of expertise include Medicare Advantage (MA) and pharmacy consulting. Phil specializes in the MA and Part D markets with a focus on MA bid submission and Star Rating strategy. Phil has led both medical and prescription drug pricing during the bid development process for numerous MA Organizations. He provides his clients strategic support and has assisted clients with understanding items, such as the impact of formulary changes, legislative proposals, plan benefit designs, provider network arrangements, risk score impacts, opportunities to increase Star Ratings, and potential new plan offerings and service area expansions. Within the pharmacy space, Phil has experience working with pharmacy benefit managers and pharmaceutical manufacturers. He has evaluated the impacts of proposed legislative changes on pharmacy supply chain stakeholders and has assisted in pharmacy rate setting processes. Phil also contributes to firmwide research and has led the development of Milliman’s prescription drug Health Cost Guidelines (Rx HCGs) and Medicare Part D trend research.