Nicholas Bauman

Nick has served many types of clients in his time with Milliman, including state government agencies, Medicare Advantage organizations, and other healthcare clients. In particular, Nick has performed extensive work related to state Medicaid programs. In his time with Milliman, Nick has worked with five state Medicaid agencies as well as Medicaid MCOs in two additional states.

Nick has worked with state Medicaid agencies on the following:

• Development and certification of actuarially sound Medicaid managed care capitation rates
• Medicaid MCO procurement and capitation rate negotiation
• Medicaid provider reimbursement rate setting
• Medicaid MCO provider contracting analysis, including development and analysis of provider incentive programs
• Medicaid program expenditure projections in support of budget development
• Development, implementation, and analysis of §438.6(c) state-directed payment arrangements
• Development and implementation of risk adjustment, high-cost risk pool, and performance-based withhold mechanisms for Medicaid managed care programs
• Analysis of other Medicaid program changes
• Analysis of in-depth encounter data
• Communication with Medicaid MCOs, Medicaid providers, CMS, and other stakeholders

Additionally, Nick’s Medicare Advantage experience includes the following:

• Development of cost and revenue projections
• Strategic assessment of product and benefit offerings
• Development of bids, supporting documentation, and responses to desk review and audit questions for submission to CMS