Michael Cook

FSA, MAAA

Principal and Consulting Actuary

Brookfield, WI, US

Main +1 262 784 2250 | Office +1 262 796 3417

Michael Cook is a principal and consulting actuary with the Milwaukee office of Milliman. He joined the firm in 2010.

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Experience

Michael’s career as a healthcare actuary started in 2000. His area of expertise is managed healthcare programs, including Medicaid and Medicare Advantage (Parts A/B and D). He has advised state and federal government agencies, as well as private insurers. Michael has worked with public programs across the nation for the majority of his career in a variety of capacities. He has worked with clients to:

Develop and certify managed care rate ranges or upper payment limits for physical health, behavioral health, PACE, home and community-based services, foster care case management, and non-emergency transportation programs.
Establish strategy around program design, rate negotiations, and contracting strategy.
Develop FFS rates for behavioral health and home- and community-based services.
Develop project Medicaid agency-wide budgets.
Complete waiver-related cost effectiveness and other financial analyses.
Evaluate Medicaid managed care rates and provide negotiation support for Medicaid health plans and associations.
Prepare Medicare Advantage Part A/B and Part D bids and respond to desk review and audit requests.

Michael advises a wide range of clients on public programs, including the following:

Served as the certifying actuary for Medicaid managed care programs in eight states.
Assisted health plans in evaluating Medicaid managed care rates in several other states.
Advised the Medicare-Medicaid Coordination Office in rate development and structure for the Financial Alignment Initiative (a.k.a. “Dual” Demonstration).

Professional Designations

Fellow, Society of Actuaries
Member, American Academy of Actuaries

Education

BA, Mathematics, St. Olaf College, Northfield, Minnesota

Affiliations

American Academy of Actuaries Medicaid Workgroup
Society of Actuaries Medicaid Subgroup

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Publications

Read their latest work

Article

Emergency Medicaid Waivers during the COVID-19 pandemic

08 April 2020 - by Katherine Wentworth, Carol H. Steckel, Jeremy Hoffman, Michael Cook, Greg J. Herrle

The COVID-19 pandemic is placing historic pressures on our healthcare system and coverage programs alike, and Medicaid programs are a key mechanism states are using to address these challenges.

Article

Actuarial soundness under Medicaid block grants and per capita caps

10 March 2017 - by Michael Cook

Actuarially sound capitation rates will remain critical to the long-term viability of Medicaid managed care programs.

Article

Functional-based risk adjustment for Medicaid Managed Long Term Services and Supports

15 June 2016 - by Michael Cook

While the planning, development, and implementation needs of a functional-based risk adjustment mechanism are significant, the improvements realized in Medicaid Managed Long Term Services and Supports programs are worth the effort.

Article

Functional-based risk adjustment for Medicaid Managed Long Term Services and Supports

15 March 2016 - by Michael Cook

As the number of Medicaid Managed Long Term Services and Supports (MLTSS) programs increases, there is also increased realization of the value of functional-based risk adjustment (FBRA) of managed care organization (MCO) capitation.

Article

How to survive (and maybe even benefit from) Medicare Advantage and prescription drug bid reviews and audits

20 June 2011 - by Michael Cook

Strategies for making bid reviews and audits relatively painless—while improving the quality of bid development and business planning processes.

Michael Cook

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Experience

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Read their latest work

Emergency Medicaid Waivers during the COVID-19 pandemic

Actuarial soundness under Medicaid block grants and per capita caps

Functional-based risk adjustment for Medicaid Managed Long Term Services and Supports

Functional-based risk adjustment for Medicaid Managed Long Term Services and Supports

How to survive (and maybe even benefit from) Medicare Advantage and prescription drug bid reviews and audits

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Michael Cook

Experience

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