Kimberley Hiemenz
Kim Hiemenz is a principal and consulting actuary with the Milwaukee office of Milliman. She joined the firm in 2006 after working for two large insurance carriers.
Experience
Kim has extensive experience with managed care payment structures, including shared-risk and population-based payment arrangements. Further, Kim is very well versed in the Affordable Care Act (ACA) and Medicare Advantage (MA). She assists clients with ACA pricing and filings, and MA feasibility studies and bid development.
Kim provides financial and strategic risk management support to her clients. She assists clients with several facets of their business, including product development and pricing, experience analysis, valuation of reserves, financial reporting, and development of risk-sharing arrangements.
Kim’s clients include integrated delivery systems, hospitals, health plans, including provider-owned health plans, and Associations / Trusts.
Examples of Kim's engagements include:
- Developing risk-based reimbursement models, including financial projections under various scenarios
- Developing strategic analyses and payer contracting strategies
- Developing pricing and filing structures for ACA products
- Estimating Incurred But Not Reported (IBNR) claim liabilities
- Developing customized utilization and cost benchmarks
- Performing MA feasibility studies and bid development
- Co-Author, Providers, are you ready for employer-led accountable care? March 2019.
- Co-Author, Will "Repeal and Replace" of the ACA cause pent-up demand to occur? March 2017.
- Co-Author, Providers should do annual check-ups on Medicare Advantage risk-sharing contracts, January 2017.
- The essential eight: Keys to successful ACO contracting, October 2015.
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
- Member, American College of Healthcare Executives
- Member, Healthcare Financial Management Association
- Members, National Association of Professional Women
- BS, Double Major in Mathematics and Risk Management / Financial Services, Illinois Wesleyan University