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Ben Mori

Principal and Sr. Healthcare Consultant
Seattle, WA, US

Ben Mori is a principal and senior healthcare consultant in the Medicaid Finance and Policy Practice in the Seattle office of Milliman. He joined the firm in 2018.

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Experience

Ben provides healthcare consulting services focused on empowering payers to transform service delivery through payment. He has more than 20 years of experience using analytics to develop payments consistent with enhancing resource efficiency and access to quality healthcare for both public and commercial payers. Ben’s expertise includes the development of prospective reimbursement systems to achieve payment transformation for healthcare payers, including inpatient and outpatient hospitals, home- and community-based service (HCBS) providers, long-term acute care hospitals, nursing facilities, and professional service providers. Ben also is experienced in assisting State Medicaid agencies with program funding strategies to optimize federal funding opportunities, maintain access to care, and incentivize improved patient quality and outcomes. Ben has extensive project management and leadership experience, including directing multiple large-scale engagements for nine state agencies, three commercial BlueCross BlueShield plans, and the Veterans Health Administration, impacting over 35 million lives.

Publications

Read their latest work

Article

State-directed payment considerations for the CMS Medicaid and CHIP Managed Care Access, Finance, and Quality proposed rulemaking

12 May 2023 - by Ben Mori, Amanda Schipp, Jason Clarkson, Carmen Laudenschlager, Luke B.G. Roth
We review the essentials for states to consider regarding the proposed changes by CMS for Medicaid and Children’s Health Insurance Program Managed Care Access.
Article

Meeting the needs of Medicaid Home and Community-Based Services program participants during the COVID-19 pandemic and beyond

12 May 2020 - by Kristina Moorhead, Jill Herbold, Ben Mori, Mary Pat Stemnock, Katherine Wentworth
The COVID-19 pandemic presents unique challenges for Medicaid Home and Community-Based Services program participants.
Article

Designing payment arrangements for Medicaid providers in response to the COVID-19 emergency

30 April 2020 - by Luke B.G. Roth, Ben Mori, James Pettersson, Joseph Whitley, Carol H. Steckel
While large for-profit healthcare provider entities with existing capital reserves or greater access to capital markets may be able to weather the financial strain caused by the COVID-19 pandemic, other small, rural, or safety net provider entities may require additional support to keep their doors open.
Article

State considerations regarding Medicaid Fiscal Accountability Regulation proposed by CMS

07 January 2020 - by Ben Mori, Tyler Schulze, Jason Clarkson
This paper contains a summary of the key elements of the Medicaid Fiscal Accountability Regulation’s proposed changes to supplemental payments that may be relevant to state Medicaid agencies.
Article

Approved Medicaid State Directed Payments: How States are Using §438.6(c) “Preprints” to Respond to the Managed Care Final Rule

30 October 2018 - by James Pettersson, Ben Mori, Luke B.G. Roth, Jason Clarkson
This paper provides a background on state directed payment arrangements based on our review of §438.6(c) “Preprints” and supporting documentation for arrangements approved by the Centers for Medicare and Medicaid Services as of August 15, 2018.