Katie Matthews

FSA, MAAA

Consulting Actuary

Denver, CO, US

Katie Matthews is a consulting actuary with Milliman’s Health Practice. She is located in Denver, Colorado, and joined the firm in 2013.

1 303 672 9060

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Experience

Katie has 10 years of experience as a consulting actuary in the healthcare industry. Much of this work includes pricing, rate filings, and return-on-investment (ROI) analyses, with a specific focus in the behavioral health space. Her recent work has included strategic consulting around and in the development of ACA rate filings in multiple states, ROI analysis of multiple care management and integration programs with varying care model structures, and with health plan issuers and employers in determining compliance under the Mental Health Parity and Addiction Equity Act (MHPAEA). Katie has completed substantial research regarding the impact of MHPAEA and opioid use disorder on utilization of healthcare services and other costs.

Katie has also worked with commercial insurers in developing strategic payment mechanisms that best fit insured populations, risk adjustment analysis, and MLR and year-end financial reporting.

She is also heavily involved with the development and maintenance of the Milliman Underwriting Guidelines.

Publications and Presentations

Economic costs of the opioid crisis for employers (co-author), August 2020.
Financial sustainability of an integrated medical-behavioral primary care practice (co-author), June 2019.
Opioid use disorder: Costs, utilization, and comorbidities (co-author), May 2019.
Opioid use disorder in the United States: Diagnosed prevalence by payer, age, sex, and state (co-author), March 2018.
Potential economic impact of integrated medical-behavioral healthcare: Updated projections for 2017 (co-author), February 2018.
Impact of Mental Health Parity and Addiction Equity Act (co-author), November 2017.
Nonquantitative treatment limitations in the spotlight (co-author), October 2017.
Society of Actuaries Mental Health Parity and Addiction Equity Act – 2019 Update Webcast (presenter).
American College of Preventive Medicine Prevention 2019 (presenter).
Society of Actuaries 2018 Health Meeting (presenter).
Society of Actuaries 2018 Annual Meeting (presenter).
American Society of Addiction Medicine Conference 2018 (presenter).

Professional Designations

Fellow, Society of Actuaries
Member, American Academy of Actuaries

Education

BS (Summa Cum Laude), Actuarial Science
BA, Music, Business minor, Economics minor, Florida State University

Publications

Read their latest work

Article

Independent review of Summus Global’s client savings estimation methodology

14 December 2022 - by Frederick (Fritz) Busch, Katie Matthews

We examine the appropriateness of the methodologies used by Summus, a virtual specialty care platform, for the company’s analysis of client savings.

Article

Economic costs of the opioid crisis for employers

03 August 2020 - by Stoddard Davenport, Matt Caverly, Katie Matthews

The economic costs (both direct and indirect) of nonmedical opioid use are substantial to U.S. employers, not only due to lost productivity, but also due to increased healthcare expenditures, greater costs for workers’ compensation and disability claims, and difficulty meeting recruitment or production targets in regions that experience shortages of workers.

Article

Financial sustainability of an integrated medical-behavioral primary care practice

03 June 2019 - by Katie Matthews, Stephen P. Melek, Ally Weaver

The state of Colorado has implemented behavioral healthcare in primary medical care settings under a Centers for Medicare and Medicaid Services State Innovation Model Award.

Article

Opioid use disorder: Costs, utilization, and comorbidities

23 May 2019 - by Katie Matthews, Ally Weaver

Many patients with opioid use disorder have complex healthcare needs, contributing to their significant healthcare costs.

Article

Opioid use disorder in the United States: Diagnosed prevalence by payer, age, sex, and state

09 March 2018 - by Stoddard Davenport, Katie Matthews

Over 25 million American adults report suffering from daily chronic pain. The increasing use of opioids in recent years has taken a human toll, leading to a rising number of overdose deaths and diagnoses of opioid use disorder.

Article

Potential economic impact of integrated medical-behavioral healthcare: Updated projections for 2017

12 February 2018 - by Stoddard Davenport, Katie Matthews, Stephen P. Melek, Doug Norris, Ally Weaver

This report uses healthcare cost and utilization data to project spending estimates for people with chronic medical and comorbid behavioral conditions in 2017.

Article

Impact of Mental Health Parity and Addiction Equity Act

22 November 2017 - by Stoddard Davenport, Michael Mager, Katie Matthews, Stephen P. Melek, Daniel Perlman

What has happened to utilization and costs for mental health and substance use disorder benefits as the mental health parity laws and associated rules were slowly rolled out?

Article

Nonquantitative treatment limitations in the spotlight

26 October 2017 - by Stoddard Davenport, Katie Matthews, Stephen P. Melek, Daniel Perlman

Nonquantitative treatment limitations continue to be a source of difficulty for many health plans in attaining compliance with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008.