James Johnson

James works in Milliman’s Healthcare Practice. He has assisted with Medicaid managed care rate setting and capitated risk adjustment. James has assisted with the following projects:

• Capitation rate setting and risk adjustment for the State of Minnesota's managed Medicaid programs
• Capitation rate setting and risk adjustment for the managed long-term care programs for Minnesota, Florida, and Wisconsin
• Development of a risk adjustment model for the State of Wisconsin's managed Medicaid programs
• Benefit design and health status methodology adjustment for the State of Minnesota's Basic Health Plan
• Development of a risk-based funding allocation model for PIHPs providing mental health services for the State of Michigan's Medicaid program
• Capitation rate review and advocacy on behalf of managed care organizations participating in Medicaid programs across 10 states
• Development and management of sub-capitation rates for behavioral health, dental, vision, and transportation vendors, including regulatory interfacing
• Responding to managed care procurement efforts across several states, including state procurement efforts involving cost-based responses