Annie P Hallum
FSA, MAAA
Principal & Consulting Actuary
Seattle, WA, US
Annie Hallum is a principal and consulting actuary with Milliman’s Seattle Health Practice. She has worked for the firm from 2009 to 2015, and from 2019 to the present.
Experience
Annie has experience in providing actuarial support and consulting services to state Medicaid agencies, health plans, and providers in more than 10 states.
Annie's actuarial experience includes Medicaid rate setting, health policy and waiver support, Medicare Advantage premium rate development, Medicaid Managed Care procurement support, state budget projections, legislative impact analysis, and audit support.
Recent projects include:
- Medicaid rate setting for managed care programs covering physical health, behavioral health, and dental benefits for low-income family, blind and disabled, ACA adult expansion, foster care, and CHIP populations
- Long-term services and supports provider payment rate development and financial projections
- Development of upper payment limits and certification of Medicaid capitation rates for Programs of All-Inclusive Care for the Elderly (PACE)
- Support for 1915(b)/(c) and 1115 waiver design, application, and implementation
- Design and implementation of inpatient and outpatient Medicaid payments models using All Patients Refined Diagnosis Related Groups (APR-DRGs) inpatient payment rates and Enhanced Ambulatory Patient Groups (EAPGs)
- Medicaid Managed Care procurement support
- Analysis of state provider assessments and payments to hospitals and physician groups to promote Medicaid provider access
- Upper payment limit demonstrations for nursing home, inpatient, outpatient, professional, and clinic services
- Alternative payment model design, including bundled payment rates and hospital all-payer budgets
- Actuarial modeling of healthcare variables to test their impact of proposed changes to current and projected healthcare costs
- Development and analysis of changes to provider reimbursement
Professional Designations
- Member, American Academy of Actuaries (MAAA)
- Fellow, Society of Actuaries (FSA)
Education
- BS, Statistics, University of Washington
- BA, Mathematics and Economics, University of Washington
Publications
Read their latest work
Article
CY 2025 Medicare Advantage Rate Announcement and final rule: What do Medicaid leaders need to know?
08 July 2024 - by Jessica Bertolo, Annie P Hallum, Nicholas Johnson
We outline the key policy and financial impacts of the 2025 Medicare rules for Medicaid agencies.
Article
Navigating the Intersection of Medicare and Medicaid – Dual-Eligible Beneficiaries
12 April 2024 - by Zachary Fohl, Dean Johnson, Nick Gipe, Annie P Hallum, Jessica Bertolo, Marlene Howard, Nicholas Johnson
We provide an overview of the complexities surrounding the intersection of Medicare and Medicaid, and explore opportunities to better serve dual-eligible beneficiaries.
Article
Key insights into 2024 Medicare Advantage D-SNP landscape
05 March 2024 - by Nicholas Johnson, Annie P Hallum, Nick Gipe
As the Medicare Advantage D-SNP market evolves, MAOs, states, and other stakeholders will need to understand the financial and competitive implications.
Article
Key insights into 2023 Medicare Advantage D-SNP landscape
07 April 2023 - by Nicholas Johnson, Annie P Hallum, Nick Gipe
We present six key insights into the changing landscape for Medicare Advantage’s dual-eligible special needs plans (D-SNPs) for calendar year 2023.
Article
Key insights into 2022 Medicare Advantage D-SNP landscape
01 February 2022 - by Nicholas Johnson, Annie P Hallum, Nick Gipe
We offer key insight on the growing market of dual eligible special needs plans, which enroll beneficiaries who are both eligible for Medicare and Medicaid.
Article
Medicaid long-term services and supports
01 February 2022 - by Jill A. Bruckert, Annie P Hallum, Davis Burge
We illustrate potential short-term and long-term savings opportunities, including fee-for-service and managed care.
Article
Direct Contracting Duals Model: Medicaid MCOs managing Medicare FFS costs for dual-eligible beneficiaries
08 February 2021 - by Nicholas Johnson, Sam Shellabarger, Annie P Hallum
Centers for Medicare and Medicaid introduced the Direct Contracting entity for individuals dually eligible for Medicaid and Medicare in December 2020.
Article
Direct Contracting Duals Model: Medicaid MCOs managing Medicare FFS costs for dual-eligible beneficiaries
04 February 2021 - by Nicholas Johnson, Sam Shellabarger, Annie P Hallum
This white paper summarizes the new Direct Contracting option that the Centers for Medicare and Medicaid Services introduced in December 2020.
Article
Key insights into 2021 Medicare Advantage D-SNP landscape
18 November 2020 - by Nicholas Johnson, Annie P Hallum, Nick Gipe
What are some key insights into the calendar year 2021 dual eligible special needs plan landscape?
Article
Medicaid dental program delivery systems
11 May 2020 - by Joanne Fontana, Annie P Hallum, Catherine E Lewis
This paper outlines the options for Medicaid dental delivery systems, their current usage, and considerations for each option.