Andrew has assisted clients across the health insurance industry, specifically in the area of managed healthcare programs. He has advised state government agencies, hospital systems, insurance companies, MCOs, and other healthcare clients. His experience with Medicaid coverage from the perspective of insurers, providers, and government stakeholders enables him to provide unique insight on a wide range of issues.
Andrew's area of expertise is Medicaid and managed Medicaid programs from both a state and managed plan perspective. He has assisted clients on multiple Medicaid issues, including:
- Serving as the certifying rate-setting actuary for Florida's Statewide Medicaid Managed Care (SMMC) program
- Assisting Florida in the evaluation of which Medicaid managed care organizations were the best value for the Florida Medicaid SMMC program
- Serving as the certifying rate-setting actuary for the Minnesota Medicaid Department of Human Services under the Prepaid Medical Assistance Program and the Minnesota Care Program
- Leading the development of a risk scoring methodology and assisting health plans in understanding the process in the Minnesota Care Program
- Evaluating the impact of the Affordable Care Act on state Medicaid programs, including analyzing the effect of membership movement in Minnesota
- Modeling future hospitalizations due to the COVID-19 pandemic
- Modeling provider reimbursement rates for outpatient and inpatient hospital services for Florida's SMMC program
- Creating a nationwide study evaluating the prevalence of Hepatitis C among state prison and Medicaid members, as well as determining the long-term costs and savings for providing various treatments
- Evaluating Medicaid managed care rates and providing negotiation support for Medicaid managed care organizations
- Assisting CMS in evaluating state capitation rates for the Dual Demonstration Program
