Danjie is an experienced actuary with more than 10 years of healthcare experience across both health plan and consulting environments. She has worked with health plans, hospital systems, and provider groups, and joined Milliman in 2019.Her primary areas of experience as a healthcare actuary include:
Developing provider reimbursement benchmarking and comparison tools that identify contract improvement opportunities
Supporting Medicare Advantage and Part D bid modeling and feasibility studies
Estimating quarterly and year-end Incurred But not Reported (IBNR) claims and premium deficiency reserves
Serving as an expert with Medicare fee schedules, including Inpatient Rehabilitation Fee Schedules and Inpatient Psychiatric Fee Schedules
Supporting clients in analysis claims and membership to inform product, network, and performance decisions
Publications and Presentations
Commercial Reimbursement Benchmarking: Commercial payment rates for medical services as percentage of Medicare Fee-for-Service rates
Professional Designations
Fellow, Society of Actuaries
Member, American Academy of Actuaries
Education
Dual MS, Business Analytics /Quantitative Finance and Risk Analytics, Rensselaer Polytechnic Institute
BS, Mathematics and Applied Mathematics, Beijing Forestry University
01 November 2024 - by Spencer Marshall, Danjie Zhou, Charlie Mills
We review the key pricing factors for the latest guidance issued by CMS for Medicare inpatient and outpatient prospective payment systems, for fiscal year 2025.
20 November 2023 - by Casey Anderson, Charlie Mills, Danjie Zhou, Andy McBeth
Healthcare provider reimbursement as a percentage of Medicare fee-for-service rates provides a consistent and well-understood basis for comparing reimbursement rates.
01 November 2022 - by Andy McBeth, Charlie Mills, Danjie Zhou
Provider reimbursement as a percentage of Medicare fee-for-service rates provides a consistent and well-understood basis for comparing reimbursement rates.
09 August 2022 - by Austin Barrington, Deana Bell, Danjie Zhou
We analyze nationwide professional commercial, Medicaid and Medicare claims from 2020 to gauge the average cost and utilization for audiology services.
01 July 2021 - by Andy McBeth, Charlie Mills, Danjie Zhou
We estimate 2021 commercial reimbursement for medical services to be about 190% of fully-loaded Medicare, with a big difference between facility and professional.
