Our Company

Jim B. Pettersson

Senior Healthcare Consultant
Seattle, WA, US

Tel: +1 206 5045765

E-Mail | Download bio

Education

  • BS, Accounting, Central Washington University

Current Responsibility

Jim Pettersson is a senior healthcare consultant with the Medicaid Finance and Policy practice in Milliman’s Seattle office. He joined the firm in 2018.

Experience

Jim has more than 30 years of experience providing consulting and advisory services to state Medicaid programs and state agencies, private insurers, hospital providers and other healthcare entities. He specializes in the design, implementation, and evaluation of healthcare delivery and payment systems for all types of provider services, and the evaluation of the adequacy of payment rates. His experience includes inpatient and outpatient hospital services, nursing facility services, and home and community-based services for aged and disabled populations, persons with intellectual and developmental disabilities, and behavioral health needs.

Jim also has significant experience in the development of programs and related analyses to support opportunities for successfully leveraging federal funding for payment of provider services, and the regulatory and compliance considerations associated with enhanced and supplemental payment programs.

Presentations and Publications

  • Author, “Approved Medicaid State Directed Payments: How States are Using §438.6(c) “Preprints” to Respond to the Managed Care Final Rule”. White Paper. October, 2018.
  • Author, “Insights for Designing Effective Medicaid Readmissions Policies.” Issue brief. February, 2017.
  • Presenter, “Recent Trends in Medicaid – Local and National Perspectives.” WA-AK HFMA Annual Conference & Trade Fair. Seattle, WA. February, 2015.
  • Presenter, “The Implementation of Severity-Adjusted DRGs and Considerations for Ongoing Health Plan Operation.” World Research Group Seminars. Chicago, IL, September, 2008. Scottsdale, AZ, February, 2009.
  • Presenter, “Participant Direction in Home and Community-Based Waivers and Ratesetting to Support Individual Budgets.” National Association of Reimbursement Officers, Annual Conference. Seattle, WA. August, 2008.
  • Presenter, “The DOORS Model – A 2007 Update.” National Association of State Units on Aging, 23rd National HCBS Conference. Albuquerque, NM. October, 2007.
  • Author, “New Kid in Town – Medicare and Medicaid APCs.” Healthcare Financial Management. January, 2006.
  • Presenter, “What are the Costs of Developmental Disabilities in an HCBS Setting?” National Association of State Units on Aging, 22nd National HCBS Conference. Minneapolis, MN. October, 2006.
  • Presenter, “State Revenue Enhancement Using Federal Matching Funds – Avoiding Federal Challenges.” American Association of Public Welfare Attorneys, National Meeting. Denver, CO. September, 2004.
  • Presenter, “Becoming More Effective Users of Data in Managed Care.” HFMA, Annual National Institute. Seattle, WA. June 2002.
  • Work at Milliman

    • “I was offered a chance to come in, shake things up, create something."
    Work at Milliman