Michael Rodrigues

Michael has more than a decade of experience in the healthcare industry, with a primary focus on value-based care (VBC). He works extensively with Medicare accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP), ACO REACH, and other initiatives led by the Center for Medicare and Medicaid Innovation (CMMI). Michael supports ACOs, VBC enablers, and healthcare providers across a range of areas, including:

• Providing strategic support for Medicare ACOs, including selection of the optimal Centers for Medicare and Medicaid Services (CMS) / CMMI program and participation options
• Evaluating, developing, and optimizing ACO structures
• Monitoring individual provider performance
• Assisting with shared savings and loss distribution methodologies
• Analyzing policy changes and their impact on CMS and CMMI VBC programs
• Reviewing private-sector risk-sharing agreements
• Performing provider reimbursement benchmarking

Michael also contributes to the development of Milliman’s ACO Builder Model, supporting data validation, model testing, and providing assistance to licensed users.

Beyond his work with VBC enablers and healthcare providers, Michael has supported a state government agency in developing Medicaid managed care capitation rates. His responsibilities have included analyzing financial reporting data, evaluating the impact of physician incentive programs and preparing technical responses to inquiries from Managed Care Organizations and the CMS.

Prior to joining Milliman, Michael served as an actuary for two national, publicly traded health insurance companies. In these roles, he supported the pricing of ACA-compliant individual and small group plans for various state government agencies.