Peter Hallum

Peter is an experienced professional who has assisted government and private payers to evaluate, design, and implement payment systems that align patient outcomes with reimbursement. In addition, Peter has consulted in the actuarial and operations fields working on actuarial rate setting, Medicare Advantage bids, risk adjustment, pricing model development, and data and statistical analysis. Working to align facility payments with patient outcomes for state programs, he developed the original implementation of the State of Illinois Medicaid readmission policy, supported the State of Wisconsin’s provider outcomes dashboarding, and demonstrated patient outcome benchmarking to Arizona’s Medicaid Department.

His consulting roles include:

• Provider reimbursement benchmarking for private payers
• State Medicaid agency and private payer payment system reform – including Wisconsin, Illinois, Arizona, Florida, and several private payers
• Fee schedule development and modeling
• State Medicaid agency waiver support – Arizona and Wisconsin
• Medicare Advantage and Medicare Part D bid development and support