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Luke B.G. Roth

Senior Healthcare Consultant
Seattle, WA, US

Tel: +1 206 5945841

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Education

  • BA, Mathematics, University of Washington

Current Responsibility

Luke Roth is a senior healthcare consultant with the Medicaid Finance and Policy Practice. He rejoined the firm in 2018.

Luke provides strategic guidance and transformative solutions to healthcare leaders and policymakers as they navigate the unique risks and opportunities facing their organizations. As a member of the Medicaid Finance and Policy Practice, he assists state Medicaid programs in the areas of:

  • Medicaid program funding strategies, including development and implementation of health care-related taxes, intergovernmental transfer (IGT) programs, and certified public expenditure (CPE) programs.
  • Supplemental payments strategy, including development and implementation of FFS supplemental (UPL) payments, managed care pass-through payments, state directed 438.6(c) payments, uncompensated care pool (UCP) payments, and disproportionate share hospital (DSH) payments.
  • Hospital inpatient and outpatient payment system design and rate setting, including inpatient DRG-based payment systems, outpatient EAPG-based payment systems, and outcomes-based incentive payments.
  • Long-term services and supports (LTSS) payment system design and rate setting, including nursing home services and home- and community-based services.

Professional Contributions

  • 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.
  • Member, “CMS Hospital Wide 30-Day All-Cause Unplanned Readmission Measure for Medicaid Beneficiaries” Technical Expert Panel (TEP). March 2017 to September 2017.
  • Author, “Insights for Designing Effective Medicaid Readmissions Policies.” Issue Brief. February 2017.
  • Presenter, “Transitioning to ICD-10: Considerations for Quality Measures and Strategies for Managing Operational and Financial Risk.” CMS State Medicaid Technical Assistance Webinar. April 2015.
  • Presenter, “Recent Trends in Medicaid – Local and National Perspectives.” WA-AK HFMA Annual Conference & Trade Fair. Seattle, WA. February 2015.
  • Author, “Providers Bear Significant Risk in Payer ICD-10 Remediation Strategy and Execution.” Journal of Health Care Compliance Volume 16, Number 2. March 2014.
  • Presenter, “ICD-10 Conversion for Payers.” National Association of State Human Services Finance Officers. Phoenix, AZ. December 2013.
  • Presenter, “Bundled Payments for Acute Episodes of Care.” National Association of State Human Service Finance Officers. Phoenix, AZ. December 2013.
  • Work at Milliman

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