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Jill Herbold headshot

Jill Herbold

FSA, MAAA
Principal and Senior Consulting Actuary
Indianapolis, IN, US

Jill is an actuary with the Indianapolis office of Milliman. She joined the firm in 2009.

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Experience

Jill has developed an expertise in the analysis of the financial risks associated with the financing and delivery of healthcare services. She routinely works with self-funded groups, insurance companies, managed care organizations, and provider organizations. Her projects have included:

  • Self-funded financial projections
  • Benefit plan design
  • Quarterly reserve reviews
  • Annual reserve opinions
  • Retiree medical evaluations
  • Provider payment benchmarking
  • Provider contract evaluations
  • Small employer certifications and compliance
  • Stop-loss rating
  • Health plan pricing and rate filings

Recently, Jill has been involved with a variety of opportunities supporting provider payment reform, including:

  • Shared savings agreement design and financial evaluation
  • Patient-centered medical home programs
  • Healthcare cost savings opportunities assessments
  • Patient health management
  • Patient-level actionable information
  • Physician, hospital, skilled nursing facility, and home health provider performance evaluation

Prior to joining Milliman, Jill worked with CIGNA for 16 years.

Publications

Read their latest work

Article

Differences in nursing home usage and services across the United States

16 March 2021 - by Jill Herbold
States with higher nursing home penetration rates may have a significant opportunity to reduce costs and improve patient satisfaction.
Article

COVID-19 and the future of HCBS

15 September 2020 - by Jill Herbold, Nicholas Johnson
This paper discusses some challenges faced, actions taken, and the impact that the COVID-19 pandemic may have on home and community-based services for years to come.
Article

Meeting the needs of Medicaid Home and Community-Based Services program participants during the COVID-19 pandemic and beyond

12 May 2020 - by Kristina Moorhead, Jill Herbold, Ben Mori, Mary Pat Stemnock, Katherine Wentworth
The COVID-19 pandemic presents unique challenges for Medicaid Home and Community-Based Services program participants.
Article

Moving to a single PDL for a state's Medicaid program

10 January 2020 - by Jill Herbold, Melanie K. Kuester
This paper discusses several decision points and considerations for states evaluating a single preferred drug list requirement.
Article

“Pathways to Success” MSSP final rule: Financial benchmark

22 February 2019 - by Cory Gusland, Jill Herbold, Emma Kramer, Charlie Mills
This paper discusses the changes to the financial benchmark methodology that measures the gross savings or losses of an accountable care organization under the Medicare Shared Savings Program.
Article

“Pathways to Success” MSSP proposed rule: Assignment changes to identification of E&M Services in skilled nursing facilities

19 October 2018 - by Jill Herbold, Anders Larson
This paper discusses the current and proposed rules related to evaluation and management services in the Medicare Shared Savings Program.
Article

“Pathways to Success” MSSP proposed rule: Financial benchmark

28 August 2018 - by Cory Gusland, Jill Herbold, Charlie Mills
This paper discusses “Pathways to Success” and the important implications in store for Medicare accountable care organizations.
Article

What predictive analytics can tell us about key drivers of MSSP results

28 September 2017 - by Cory Gusland, Jill Herbold, Anders Larson
This article provides insight into the 2015 gross savings/(losses) achieved by accountable care organizations in their third performance year of the Medicare Shared Savings Program.
Article

2015 commercial health insurance: Overview of financial results

21 March 2017 - by Jason Clarkson, Zachary Fohl, Jill Herbold, Paul R. Houchens
This report provides an overview of health insurer financial results in 2015 and evaluates changes in the health insurance industry’s expense structure and enrollment relative to prior years.
Article

Performance of skilled nursing facilities for the Medicare population

09 December 2016 - by Jill Herbold, Anders Larson
This report discusses a framework and metrics for measuring skilled nursing facility (SNF) performance, explores SNF performance levels across the United States, and provides a quantitative assessment of the opportunity to reduce spending for SNF services through steerage of patients to more cost-efficient SNFs.