John Miller

Actuary

Berwyn, PA, US

John Miller is a consulting actuary with the Philadelphia office of Milliman. Formerly an actuary at Cigna, he joined the firm in 2021.

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Experience

John is an actuary in the healthcare space, with a focus on Medicare Advantage. Within this domain, he specializes in Part C bids. He also brings two years of experience pricing Affordable Care Act plans while working in the industry and responding to Department of Insurance objections. Additionally, he has experience with RADV audits, risk score models, gain-sharing arrangements, provider contracting and negotiation, stop-loss pricing, and data analysis in the VRDC.

He attained his FSA in November of 2020, and was selected as a Rising Actuary recipient in September 2023.

Publications and Presentations

https://www.milliman.com/en/insight/stakeholder-perspectives-on-the-transformative-ira-part-d-benefit-redesign

https://www.milliman.com/en/insight/what-court-rulings-say-about-medicare-advantage-diagnosis-submissions

Professional Designations

FSA, MAAA

Education

Majors in Statistics with Actuarial Science (Eberly), Finance (Smeal), and Economics (Liberal Arts). Graduated Magna Cum Laude, Pennsylvania State University

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Publications

Read their latest work

Article

Falling Star Rating trajectory: 2027 Proposed Rule implications

08 December 2025 - by Hayley M. Rogers, Matthew Smith, John Miller, Brandon Campbell

With significant proposed changes to the Star Ratings program for Medicare Advantage and Part D, we detail the implications for contract year 2027.

Article

Stakeholder perspectives on the transformative IRA Part D benefit redesign

21 December 2023 - by Bruce S. Pyenson, Jennifer Carioto, Michael Rothschild, John Miller, Stephanie Leary

We discuss how the Inflation Reduction Act could affect Medicare Part D plans, members, the government, and pharmaceutical manufacturers.

Article

What court rulings say about Medicare Advantage diagnosis submissions

06 December 2021 - by Sylvia Hagin, John Miller

What is the responsibility of an insurer in returning payments received from miscoded diagnoses?

John Miller

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Experience

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Read their latest work

Falling Star Rating trajectory: 2027 Proposed Rule implications

Stakeholder perspectives on the transformative IRA Part D benefit redesign

What court rulings say about Medicare Advantage diagnosis submissions

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John Miller

Experience

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