Michael Cook
FSA, MAAA
Principal and Consulting Actuary
Brookfield, WI, US
Michael Cook is a principal and consulting actuary with the Milwaukee office of Milliman. His career as a healthcare actuary started in 2000.
Experience
Michael’s area of expertise is managed healthcare programs, including Medicaid and Medicare Advantage (Parts A/B and D). He has advised state and federal government agencies, as well as private insurers.
Michael has worked with public programs across the nation for the majority of his career in a variety of capacities. He has worked with clients to:
- Develop and certify managed care rate ranges or upper payment limits for physical health, behavioral health, PACE, home and community-based services, foster care case management, and non-emergency transportation programs.
- Establish strategy around program design, rate negotiations, and contracting strategy.
- Develop FFS rates for behavioral health and home- and community-based services.
- Develop project Medicaid agency-wide budgets.
- Complete waiver-related cost effectiveness and other financial analyses.
- Evaluate Medicaid managed care rates and provide negotiation support for Medicaid health plans and associations.
- Prepare Medicare Advantage Part A/B and Part D bids and respond to desk review and audit requests.
Michael advises a wide range of clients on public programs.
- Michael serves as the certifying actuary for programs in Minnesota and Wisconsin. He was previously the certifying actuary for six other states.
- He has assisted health plans in evaluating Medicaid managed care rates in several other states.
- Michael has advised the Medicare-Medicaid Coordination Office in rate development and structure for the Financial Alignment Initiative (a.k.a. “Dual” Demonstration).
Professional Designations
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
Education
- BA, Mathematics, St. Olaf College, Northfield, Minnesota
Affiliations
- American Academy of Actuaries Medicaid Workgroup
- Society of Actuaries Medicaid Subgroup
Publications
Read their latest work
Article
Emergency Medicaid Waivers during the COVID-19 pandemic
08 April 2020 - by Katherine Wentworth, Carol H. Steckel, Jeremy Hoffman, Michael Cook, Greg J. Herrle
The COVID-19 pandemic is placing historic pressures on our healthcare system and coverage programs alike, and Medicaid programs are a key mechanism states are using to address these challenges.
Article
Actuarial soundness under Medicaid block grants and per capita caps
10 March 2017 - by Michael Cook
Actuarially sound capitation rates will remain critical to the long-term viability of Medicaid managed care programs.
Article
Functional-based risk adjustment for Medicaid Managed Long Term Services and Supports
15 June 2016 - by Michael Cook
While the planning, development, and implementation needs of a functional-based risk adjustment mechanism are significant, the improvements realized in Medicaid Managed Long Term Services and Supports programs are worth the effort.
Article
Functional-based risk adjustment for Medicaid Managed Long Term Services and Supports
15 March 2016 - by Michael Cook
As the number of Medicaid Managed Long Term Services and Supports (MLTSS) programs increases, there is also increased realization of the value of functional-based risk adjustment (FBRA) of managed care organization (MCO) capitation.
Article
How to survive (and maybe even benefit from) Medicare Advantage and prescription drug bid reviews and audits
20 June 2011 - by Michael Cook
Strategies for making bid reviews and audits relatively painless—while improving the quality of bid development and business planning processes.