Mathieu Doucet

FSA, MAAA

Principal and Consulting Actuary

Brookfield, WI, US

Main +1 262 784 2250 | Office +1 262 796 3440

Mathieu Doucet is a principal and consulting actuary with the Milwaukee office of Milliman. He joined the firm in 2002.

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Experience

Mathieu’s area of expertise is healthcare programs, including managed healthcare and Medicaid acute and long-term care populations. Mathieu has worked with public programs across the nation for the majority of his career in a variety of capacities. He has worked with clients to:

Develop managed care rates for physical health, behavioral health, PACE, home and community-based services, and non-emergency transportation programs
Establish strategy around program design, rate negotiations, and contracting strategy
Develop FFS rates for behavioral health and home- and community-based services
Implement risk adjustment models for acute care and managed LTC Medicaid populations
Implement risk mitigation strategies in new managed Medicaid programs
Prepare analyses to respond to Medicaid MCO concerns regarding capitation rates
Assist new and existing MCOs in evaluating state Medicaid rates by creating analogous rate ranges
Attend state rate hearings on behalf of MCOs to better understand underlying capitation rate development assumptions
Develop project Medicaid agency-wide budgets
Evaluate the impact of the Affordable Care Act on state Medicaid programs
Complete waiver-related cost effectiveness and other financial analyses
Evaluate Medicaid managed care rates and provide negotiation support for Medicaid health plans and associations

He has assisted clients with provider capitation analyses, pricing, valuation of liabilities, product design, financial projections, financial reporting, and experience analysis. Mathieu has advised many organizations, including HMOs, insurance companies, Medicaid health plans, state agencies, employers, and healthcare providers. He is experienced with reserve calculation, experience analysis through the use of databases and statistical programming, production of utilization benchmarks, and projection of commercial, Medicare, and Medicaid utilization and costs.

Mathieu’s prior experience, which included development of Medicare Advantage bids, allows him to provide additional insight to his clients in preparing responses to questions from current CMS reviewers. Mathieu is fluent in French and English.

Publications and Presentations

ACA health insurer fee: Estimated impact on the U.S. health insurance industry. Milliman Research Report, April 2013.
PPACA health insurer fee: Estimated impact on state Medicaid programs and Medicaid health plans. Medicaid Health Plans of America, January 2012.
Advancing Risk Adjustment Modeling in Managed Medicaid Long Term Care Programs. SOA Health Meeting, June 2016.
Actuarial Soundness, the CMS Rate Setting Checklist and the ACA. SOA Webcast, November 2013.
Optimizing Rate Setting for Medicaid Managed Long Term Care. 4th Annual World Medicaid Congress. Washington, DC, February 2011.

Professional Designations

Fellow, Society of Actuaries
Member, American Academy of Actuaries

Education

BS, Actuarial Sciences, Laval University, Québec

Affiliations

American Academy of Actuaries Medicaid Workgroup
Society of Actuaries Medicaid Subgroup

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Publications

Read their latest work

Article

ACA health insurer fee: Estimated impact on the U.S. health insurance industry

15 April 2013 - by Mathieu Doucet, Julia M. Friedman

What impact will the new health insurer fee provision put forth in the ACA have on the industry?

Article

PPACA health insurer fee: Estimated impact on state Medicaid programs and Medicaid health plans

31 January 2012 - by Mathieu Doucet, John D. Meerschaert

An analysis of the impact of the health insurer fee introduced in the Patient Protection and Affordable Care Act (PPACA) on state Medicaid programs and Medicaid health plans.

Experience

Develop managed care rates for physical health, behavioral health, PACE, home and community-based services, and non-emergency transportation programs
Establish strategy around program design, rate negotiations, and contracting strategy
Develop FFS rates for behavioral health and home- and community-based services
Implement risk adjustment models for acute care and managed LTC Medicaid populations
Implement risk mitigation strategies in new managed Medicaid programs
Prepare analyses to respond to Medicaid MCO concerns regarding capitation rates
Assist new and existing MCOs in evaluating state Medicaid rates by creating analogous rate ranges
Attend state rate hearings on behalf of MCOs to better understand underlying capitation rate development assumptions
Develop project Medicaid agency-wide budgets
Evaluate the impact of the Affordable Care Act on state Medicaid programs
Complete waiver-related cost effectiveness and other financial analyses
Evaluate Medicaid managed care rates and provide negotiation support for Medicaid health plans and associations

Mathieu Doucet

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Experience

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Read their latest work

ACA health insurer fee: Estimated impact on the U.S. health insurance industry

PPACA health insurer fee: Estimated impact on state Medicaid programs and Medicaid health plans

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Mathieu Doucet

Experience

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