Michael T. Hunter

PharmD

Principal and Pharmacy Management Consultant

Chicago, IL, US

Main +1 312 726 0677 | Office +1 312 499 5734

Michael Hunter is a principal and pharmacy management consultant with the Chicago office of Milliman. He joined the firm in 2014.

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Experience

Michael has over 20 years of experience in the pharmaceutical industry, including consulting services to pharmaceutical manufacturers, Medicare Part D plan sponsors, health plans, PBMs, pharmacy purchasing coalitions, drug wholesalers, retail and specialty pharmacies, and state Medicaid agencies. Michael supports his clients with payer-perspective insights regarding formulary access and payer-provider contracting.

Publications and Presentations

Specialty Pharmacy – Three Perspectives: Medicare, Medicaid, and Commercial. Society of Actuaries Health Meeting. June 2015.
PBM Contracts: Delve into Innovative Strategies to Improve Your Plan’s Bottom Line. CBI: PBM & Contracting Strategies conference. August 2015.
Medicare Part D member profitability by pharmacy channel. Milliman Insight. December 2015.
Understanding Biosimilars and Projecting Cost Savings to Employers. PGE: Biosimilars and Follow-on Biologics conference. March 2016.
Beyond Hepatitis C: Perspective on current and pipeline therapies that can impact the reinsurance and stop-loss markets. Hanover RE Experience. April 2016.
The Oncology Pipeline: Who’s paying for it? Asembia Specialty Summit. May 2016.
The “Rxisk” of adjustments in 2018 ACA risk adjustment. Milliman Insight. August 2017.
Equipping Employers and Health Plans to Managed Prescription Drug Costs. Pharmacy Benefit Management Institute National Conference. March 2018.
Commercial payers spend more on hospital outpatient drugs at 340B participating hospitals. Milliman website. March 2018.
Taking on Medicare Part D risk: Provider perspective. Milliman website. April 2019.
Estimating the impact of pharmacy costs on total health plan costs. Milliman website. June 2019.
Analysis of 340B hospitals’ outpatient department acquisition cost and commercial reimbursement for physician-administered brand medicines. Milliman website. December 2019.

Professional Designations

Member, Academy of Managed Care Pharmacy

Education

PharmD, Ohio Northern University

Publications

Read their latest work

Article

The impact of medication adherence on total healthcare costs for commercially insured patients

13 May 2025 - by Michael T. Hunter, Kali Schweitzer, Jay Blomquist, Mat Khan, Pepper Huang

For some people with diabetes, hypertension, or hyperlipidemia, there’s a stronger relationship between medication adherence and lower healthcare costs for patients with high risk scores.

Article

Reimagining pharmacy channel reimbursement within the supply chain

24 March 2025 - by Alan Van Amber, Michael T. Hunter, Jay Blomquist, AJ Ally, Ryan Cloninger, Stephen Wolff

The emergence of cost-plus reimbursement models in the pharmacy channel presents a promising alternative to better align reimbursement with acquisition costs.

Article

Analysis of 2020 commercial outpatient drug spend at 340B participating hospitals

13 September 2022 - by Michael T. Hunter, Katherine M. Holcomb, Carol J. Kim

The 340B program allows participating hospitals to obtain certain outpatient medications for reduced costs.

Article

Analysis of 340B hospitals' outpatient department acquisition cost and commercial reimbursement for physician-administered brand medicines

16 December 2019 - by Anna Bunger, Michael T. Hunter, Carol J. Kim

Article

Estimating the impact of pharmacy costs on total health plan costs

03 June 2019 - by Anna Bunger, Katherine M. Holcomb, Michael T. Hunter

Failing to account for rebates overstates the net impact of pharmacy costs to a payer’s total costs.

Article

Taking on Medicare Part D risk: Provider perspective

12 April 2019 - by Michael T. Hunter, Emma Kramer, Simon Moody

This article summarizes the key issues providers need to consider before taking on Part D risk, an increasingly common ask from Medicare Advantage organizations, and highlights some of the complexities and common barriers observed when advising provider clients on their strategies for Part D risk.

Article

Commercial payers spend more on hospital outpatient drugs at 340B participating hospitals

13 March 2018 - by Jason Gomberg, Michael T. Hunter, Carol J. Kim

This report replicates portions of the 2015 U.S. Government Accountability Office 340B report (a comparison of the per Medicare beneficiary hospital pharmacy outpatient drug spending at 340B hospitals and non-340B hospitals) on a commercially insured population to determine if the relationships found in the Medicare population existed in the commercial markets.

Article

The “Rxisk” of adjustments in 2018 ACA risk adjustment

18 August 2017 - by Michael T. Hunter, Michelle (Klein) Robb, Jason J. Petroske, Alan Vandagriff

The Centers for Medicare and Medicaid Services (CMS) is adding a new prescription drug category classification system to the 2018 risk adjustment model, and this paper approximates the likely CMS mapping based on the publicly available information to date.

Article

Medicare Part D member profitability by pharmacy channel

24 December 2015 - by Jason Gomberg, Michael T. Hunter

An analysis of 2014 Part D plan profitability to determine if specific pharmacy channels are associated with members that may be more or less profitable for a Medicare Part D carrier.

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Read their latest work

Article

The impact of medication adherence on total healthcare costs for commercially insured patients

13 May 2025 - by Michael T. Hunter, Kali Schweitzer, Jay Blomquist, Mat Khan, Pepper Huang

For some people with diabetes, hypertension, or hyperlipidemia, there’s a stronger relationship between medication adherence and lower healthcare costs for patients with high risk scores.

Article

Reimagining pharmacy channel reimbursement within the supply chain

24 March 2025 - by Alan Van Amber, Michael T. Hunter, Jay Blomquist, AJ Ally, Ryan Cloninger, Stephen Wolff

The emergence of cost-plus reimbursement models in the pharmacy channel presents a promising alternative to better align reimbursement with acquisition costs.

Article

Analysis of 2020 commercial outpatient drug spend at 340B participating hospitals

13 September 2022 - by Michael T. Hunter, Katherine M. Holcomb, Carol J. Kim

The 340B program allows participating hospitals to obtain certain outpatient medications for reduced costs.

Article

Analysis of 340B hospitals' outpatient department acquisition cost and commercial reimbursement for physician-administered brand medicines

16 December 2019 - by Anna Bunger, Michael T. Hunter, Carol J. Kim

Article

Estimating the impact of pharmacy costs on total health plan costs

03 June 2019 - by Anna Bunger, Katherine M. Holcomb, Michael T. Hunter

Failing to account for rebates overstates the net impact of pharmacy costs to a payer’s total costs.

Article

Michael T. Hunter

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Experience

Read their latest work

The impact of medication adherence on total healthcare costs for commercially insured patients

Reimagining pharmacy channel reimbursement within the supply chain

Analysis of 2020 commercial outpatient drug spend at 340B participating hospitals

Analysis of 340B hospitals' outpatient department acquisition cost and commercial reimbursement for physician-administered brand medicines

Estimating the impact of pharmacy costs on total health plan costs

Taking on Medicare Part D risk: Provider perspective

Commercial payers spend more on hospital outpatient drugs at 340B participating hospitals

The “Rxisk” of adjustments in 2018 ACA risk adjustment

Medicare Part D member profitability by pharmacy channel

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Michael T. Hunter

Read their latest work

The impact of medication adherence on total healthcare costs for commercially insured patients

Reimagining pharmacy channel reimbursement within the supply chain

Analysis of 2020 commercial outpatient drug spend at 340B participating hospitals

Analysis of 340B hospitals' outpatient department acquisition cost and commercial reimbursement for physician-administered brand medicines

Estimating the impact of pharmacy costs on total health plan costs

Taking on Medicare Part D risk: Provider perspective

Commercial payers spend more on hospital outpatient drugs at 340B participating hospitals

The “Rxisk” of adjustments in 2018 ACA risk adjustment

Medicare Part D member profitability by pharmacy channel

CHOOSE A LOCATION AND LANGUAGE