Katherine Wentworth
Katherine Wentworth is a principal and senior healthcare management consultant with the Indianapolis office of Milliman. She joined the firm in 2019.
Experience
Katherine brings over 25 years’ expertise in government-sponsored healthcare programs and managed care, aligning practical operations and program design with her deep understanding of public policy and regulatory frameworks. With her unique combination of legal and business leadership skills, she specializes in helping states conceptualize and build program innovations, assessing state and federal regulatory requirements, and managing design efforts to assure successful operational integration and ongoing program success, always focused on practical flexibility.
Katherine has deep experience developing innovative strategies to advance state Medicaid program goals such as program and delivery system reforms, quality strategy, value based payment, health-related social needs and social determinants of health, health equity, behavioral health, and managed care (including long-term services and supports and dual demonstrations).
Her work includes the development of Medicaid demonstration waivers, assessment of emerging federal regulatory requirements, development of managed care contracting strategies and procurements (including vendor oversight and readiness reviews), implementation planning, best practice assessments and program evaluations, and a variety of other regulatory, policy, and operations planning supports for her clients. Additional capabilities include stakeholder facilitation, regulatory compliance, and process assessments.
Katherine’s executive health plan leadership skills include organizational strategy, operations, customer service, outreach, information systems, and delegation oversight. She has served on a variety of industry coalitions and committees, including two gubernatorial appointments for a mental health quality advisory committee.
Prior to joining Milliman, Katherine was VP of Product Strategy and Innovation for a regional health plan serving over 2 million members, where for over three years she led corporate strategy, product strategy, business development/ proposals, and program implementations across Medicaid, Medicare Advantage, Marketplace, and other government-sponsored products. Under her leadership, Katherine's team launched health plan operations for two new Medicaid markets as well as the plan's first Medicare Dual Eligible Special Needs Plan (D-SNP).
Previously, Katherine spent 16 years with a local hospital-sponsored health plan focused on Medicaid and Marketplace, holding executive roles, including Interim CEO, COO, and General Counsel. She also served as a government affairs representative for a number of provider groups, including a state medical association and several other provider associations.
Medicaid reimbursement options to address social risks and health related social needs, February 7, 2024.
Medicaid unwinding: options for states to help people with serious mental illness maintain treatment access, July 27, 2023.
Home and community-based services payment adequacy considerations under the CMS Proposed Access Rule, June 06, 2023.
Potential coverage gaps among Medicaid beneficiaries with serious mental illness, March 7, 2023.
Updated eligibility maintenance options for state Medicaid programs to qualify for 6.2% FMAP during the COVID-19 emergency, November 10, 2020.
Meeting the needs of Medicaid Home and Community-Based Services program participants during the COVID-19 pandemic and beyond, May 12, 2020.
Emergency Medicaid Waivers during the COVID-19 pandemic, April 8, 2020.
Education
- Doctor of Jurisprudence with Health Law Concentration, Indiana University School of Law
- Executive Certificate, Business Administration, University of Notre Dame Mendoza School of Business
- Public Management Certificate, Indiana University School of Public and Environmental Affairs
- Bachelor of Arts, Political Science, Indiana University
Publications