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Michael's area of expertise is managed government-sponsored healthcare programs, including Medicaid and Medicare Advantage (Parts A, B, and D).
He has certified managed care rate ranges or upper payment limits for seven state Medicaid agencies for physical health, behavioral health, PACE, long-term care services and supports, foster care case management, and non-emergency transportation programs. He has assisted Medicaid agencies with a wide range of activities including rate negotiations, contracting strategy, FFS rate development, budgeting, waiver assistance, and quality incentive metrics.
Michael has assisted multiple Medicare Advantage organizations (including Special Needs plans) with bid preparation and feasibility studies. He also spent several years working on behalf of the Centers for Medicare and Medicaid Services to review and audit Medicare Advantage bid form development.
He also assisted the Medicare-Medicaid Coordination Office in consultation and rate review for the Financial Alignment Initiative (a.k.a. Dual Demonstration).
In addition to governmental programs, Michael has assisted commercial managed care organizations in a broad range of activities including pricing, reserving, plan design, model development, and rate filing.