Jeffrey G. Milton-Hall

Jeff is an expert in commercial health insurance, Medicaid managed care, risk adjustment, and financial reporting.

Jeff currently leads Milliman’s Affordable Care Act community of practice, has priced and prepared or certified individual ACA marketplace rate filings in over 20 states since ACA reforms were enacted, and is experienced with small and large employer group benefit design, rate development, and rate filings.

He has asisted Medicaid managed care organizations with financial reporting, forecasting, benchmarking, and rate evaluation, and has supported MCOs through the competitive bidding and negotiation process for state managed care programs (physical health, behavioral health, and dental).

Jeff's risk adjustment experience includes modeling the impact of changes to ACA and state Medicaid risk adjustment programs, evaluating Medicaid risk adjustment programs in multiple states, and assisting health plans with forecasting and optimizing risk adjustment results. His financial reporting experience encompasses evaluating premium deficiency reserves and unpaid claim liabilities, assisting with quality improvement activity reporting, forecasting medical loss ratio results, and summarizing regulatory changes to and the impacts of COVID-19 on medical loss ratio reporting. Jeff also has extensive experience modeling the impact of healthcare reform and market disruptions, including the impacts of legislative and regulatory changes (both state and federal), and he has been a leader in Milliman's COVID-19 modeling and consulting efforts.

Examples of recent projects include:

• Leading Milliman’s modeling of the American Rescue Plan of 2021 (ARPA)
• Evaluating and redesigning financial reserving and forecasting processes for a Medicaid managed care organization
• Co-authoring or peer reviewing Milliman’s ACA Payment Notice summaries since 2019
• Modeling the impacts of COVID-19 on enrollment and morbidity across state markets, and evaluating direct and indirect impacts of COVID-19 on healthcare costs in 2020, 2021, and 2022
• Developing a stochastic simulation model and associated research report to evaluate different 1332 reinsurance waiver parameters and state premium subsidy designs and their impacts on market stakeholders, premiums, and APTCs