John D. Meerschaert

FSA, MAAA

Principal, Consulting Actuary

Brookfield, WI, US

John is a principal and consulting actuary with the Milwaukee office of Milliman. He joined the firm in 1994.

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Experience

John has a diverse background in health insurance and managed healthcare programs. He has advised state government agencies, health systems, insurance companies, HMOs, and other healthcare clients. His experience with commercial, Medicare, and Medicaid coverage from the perspective of insurers, providers, and government stakeholders allows him to provide unique insight on a wide range of issues.

Public program consulting experience

John has extensive experience working with public healthcare programs and is recognized as a Medicaid industry expert. He currently serves as the state Medicaid agency's actuary in Florida, Mississippi, New Hampshire, and South Carolina. He works with his clients to:

Develop new Medicaid managed care programs
Develop and certify Medicaid managed care rates and risk adjustment calculations
Provide financial oversight of Medicaid managed care organizations
Evaluate the impact of PPACA on state Medicaid programs, including detailed analysis of the 2014 expansion population
Develop Medicaid budget projections and financial analysis of new initiatives
Evaluate Medicaid managed care rates and provide negotiation support for Medicaid health plans and provider organizations
Analyze the feasibility of starting a provider-owned Medicaid MCO
Assess the feasibility of participating in CMS dual eligible integration opportunities

Health system consulting experience

John works with health systems to analyze the financial risk of alternative contracting arrangements and provide other analytical support. He works with his clients to:

Review proposed contract language and support payer negotiations
Evaluate alternate contracting opportunities for the commercial and Medicare Advantage populations, including shared savings arrangements, capitation, quality incentive programs, bundled payments, and other structures
Identify and model alternate contracting arrangements with state Medicaid agencies and Medicaid MCOs, including direct contracting opportunities, accountable care organization structures, and capitation arrangements
Analyze the feasibility of starting a provider-owned health plan
Evaluate the impact of PPACA on health systems
Provide utilization and volume benchmarks for budgeting and planning

Professional Designations

Fellow, Society Actuaries
Member, American Academy of Actuaries

Education

BBA, Actuarial Science, Risk Management, and Quantitative Analysis, University of Wisconsin

Affiliations

Member, American Academy of Actuaries Medicaid Workgroup

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Publications

Read their latest work

Article

Growing global actuarial capacity to support sustainable economic development

28 November 2023 - by Josh Collins, John D. Meerschaert, Ong Xie

In this article for the Society of Actuaries, we review Milliman's partnership with the United Nations Development Programme to grow global actuarial capacity and support sustainable economic development.

Article

Enabling sustainable investment in social interventions: A review of Medicaid managed care rate-setting tools

06 February 2018 - by Shelly S. Brandel, John D. Meerschaert

This report identifies practical strategies that states can deploy to support Medicaid managed care plans and their network providers in addressing social issues.

Article

Healthcare reform in 2012: Blind curves ahead

23 February 2012 - by John D. Meerschaert, Michael G. Sturm

How the outcomes of the Supreme Court proceedings and the November general election may affect healthcare reform.

Article

PPACA health insurer fee: Estimated impact on state Medicaid programs and Medicaid health plans

31 January 2012 - by Mathieu Doucet, John D. Meerschaert

An analysis of the impact of the health insurer fee introduced in the Patient Protection and Affordable Care Act (PPACA) on state Medicaid programs and Medicaid health plans.

Article

Health microinsurance: Healthcare and incidence rate questionnaire

01 February 2010 - by John D. Meerschaert

These guidelines and tools for deriving incidence rate data can be used to design and price health microinsurance schemes.

Experience

Public program consulting experience

Develop new Medicaid managed care programs
Develop and certify Medicaid managed care rates and risk adjustment calculations
Provide financial oversight of Medicaid managed care organizations
Evaluate the impact of PPACA on state Medicaid programs, including detailed analysis of the 2014 expansion population
Develop Medicaid budget projections and financial analysis of new initiatives
Evaluate Medicaid managed care rates and provide negotiation support for Medicaid health plans and provider organizations
Analyze the feasibility of starting a provider-owned Medicaid MCO
Assess the feasibility of participating in CMS dual eligible integration opportunities

Health system consulting experience

John works with health systems to analyze the financial risk of alternative contracting arrangements and provide other analytical support. He works with his clients to:

Review proposed contract language and support payer negotiations
Evaluate alternate contracting opportunities for the commercial and Medicare Advantage populations, including shared savings arrangements, capitation, quality incentive programs, bundled payments, and other structures
Identify and model alternate contracting arrangements with state Medicaid agencies and Medicaid MCOs, including direct contracting opportunities, accountable care organization structures, and capitation arrangements
Analyze the feasibility of starting a provider-owned health plan
Evaluate the impact of PPACA on health systems
Provide utilization and volume benchmarks for budgeting and planning

John D. Meerschaert

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Experience

Public program consulting experience

Health system consulting experience

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Read their latest work

Growing global actuarial capacity to support sustainable economic development

Enabling sustainable investment in social interventions: A review of Medicaid managed care rate-setting tools

Healthcare reform in 2012: Blind curves ahead

PPACA health insurer fee: Estimated impact on state Medicaid programs and Medicaid health plans

Health microinsurance: Healthcare and incidence rate questionnaire

CHOOSE A LOCATION AND LANGUAGE

John D. Meerschaert

Experience

Public program consulting experience

Health system consulting experience

CHOOSE A LOCATION AND LANGUAGE