Phil Ellenberg
Healthcare Consultant
Atlanta, GA, US
Phil Ellenberg is a healthcare consultant with the Atlanta office of Milliman. He joined the firm in 2016.
Experience
Phil has over 15 years of experience working with plans and plan sponsors in a variety of capacities. By combining a unique blend of claims knowledge and analytics skills, he leverages claims data to provide actionable insights for clients across the healthcare spectrum.
Prior to joining Milliman, he worked as an appeals specialist for an independent fiduciary reviewing claims appeals for medical, pharmacy, dental, and disability. Prior to that, he worked as a paralegal for a boutique ERISA litigation firm.
Examples of his specific client work include the following:
- Comparing alternative networks based on differences in reimbursement
- Creating cost and utilization benchmarks by service and area
- Developing interactive dashboards to monitor and evaluate plan performance
- Evaluating effectiveness and return on investment of care and utilization management programs
- Designing customized total cost of care and specialized risk adjustment methodologies
- Analyzing provider reimbursement arrangements and provider contracts including fee schedules
Education
- Master of Science, Applied Statistics, Kennesaw State University
- Bachelor of Arts, Political Science, University of Georgia
Publications
Read their latest work
Article
Variation in skilled nursing facility practice patterns: Opportunities exist for more efficient management
13 September 2024 - by Kate Fitch, Jonah Broulette, Phil Ellenberg, Jaron Jackson
Our analysis of skilled nursing facilities suggests significant variation among Medicare beneficiaries in terms average length of stay and readmission rates.
Article
Medicare Advantage organizations financial results for 2022
17 November 2023 - by Phil Ellenberg, Shyam Kolli, Tushar Makhija, Greg Sgrosso
We summarize the 2022 numbers for MAOs reporting Medicare Advantage experience under the Title XVIII line on the NAIC annual statement.
Article
Medicare Advantage organizations financial results for 2021
01 December 2022 - by Phil Ellenberg, Shyam Kolli, Tushar Makhija, Greg Sgrosso
We summarize the 2021 numbers for organizations reporting Medicare Advantage experience under the Title XVIII line on the NAIC annual statement.
Article
Medicare Advantage Organizations financial results for 2020
07 March 2022 - by Phil Ellenberg, Shyam Kolli, Tushar Makhija, Greg Sgrosso
We analyze information from 374 Medicare Advantage organizations across 43 states, with the data revealing the majority of them profitable.
Article
Hospital price transparency: Impact of the shoppable file
17 March 2021 - by Josh Reinstein, Phil Ellenberg
Hospital price transparency: The impact of the shoppable file.
Article
Medicare Advantage financial results for 2019: December 2020
04 January 2021 - by Phil Ellenberg, Shyam Kolli, Tushar Makhija, Greg Sgrosso
This report summarizes the CY 2019 experience of selected financial metrics of organizations reporting Medicare experience under the Title XVIII Medicare line of business on the National Association of Insurance Commissioners Annual Statement.
Article
Price transparency: New requirements and considerations for hospitals
28 January 2020 - by Haitham Aly, Phil Ellenberg, Shyam Kolli, Josh Reinstein
This paper provides a summary of the key provisions of the price transparency final rule that apply to hospitals, briefly touching on topics that require additional consideration by parties affected by the rule.
Article
How will EDGE affect your 2019 ACA Risk Adjustment Transfer?
02 August 2018 - by Zachary M. Davis, Phil Ellenberg, Brian A. Sweatman
This paper and the accompanying interactive exhibits show the coefficients from the 2019 CMS HHS-HCC commercial risk adjustment model and compare how ACA experience from 2016 EDGE data incorporated into the 2019 model will affect risk scores, which have a direct impact on an issuer’s risk adjustment transfer.