
Danjie Zhou
FSA, MAAA
Associate Actuary
Seattle, WA, US
Danjie Zhou is an actuary with the Health Practice in the Seattle office of Milliman. She joined the firm in 2019.
Experience
Danjie is an experienced actuary with more than 10 years of healthcare experience across both health plan and consulting environments. She has worked with health plans, hospital systems, and provider groups, and joined Milliman in 2019.Her primary areas of experience as a healthcare actuary include:
- Developing provider reimbursement benchmarking and comparison tools that identify contract improvement opportunities
- Supporting Medicare Advantage and Part D bid modeling and feasibility studies
- Estimating quarterly and year-end Incurred But not Reported (IBNR) claims and premium deficiency reserves
- Serving as an expert with Medicare fee schedules, including Inpatient Rehabilitation Fee Schedules and Inpatient Psychiatric Fee Schedules
- Supporting clients in analysis claims and membership to inform product, network, and performance decisions
Publications and Presentations
Commercial Reimbursement Benchmarking: Commercial payment rates for medical services as percentage of Medicare Fee-for-Service rates
Professional Designations
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
Education
- Dual MS, Business Analytics /Quantitative Finance and Risk Analytics, Rensselaer Polytechnic Institute
- BS, Mathematics and Applied Mathematics, Beijing Forestry University
- BS, Economics, Peking University
Publications
Read their latest work
Article
Commercial reimbursement benchmarking 2025
24 July 2025 - by Spencer Marshall, Danjie Zhou, Charlie Mills
We present the latest data on reimbursement as a percentage of Medicare fee-for-service rates, a key benchmark for providers.
Article
2025 Medicare IPPS and OPPS trend summary
01 November 2024 - by Spencer Marshall, Danjie Zhou, Charlie Mills
We review the key pricing factors for the latest guidance issued by CMS for Medicare inpatient and outpatient prospective payment systems, for fiscal year 2025.
Article
Commercial reimbursement benchmarking
19 June 2024 - by Spencer Marshall, Danjie Zhou, Casey Anderson, Charlie Mills
We estimate the national commercial reimbursement payment rates increasing in 2024 to 190% of Medicare fee-for-service rates, up from 188% last year.
Article
Commercial reimbursement benchmarking
20 November 2023 - by Casey Anderson, Charlie Mills, Danjie Zhou, Andy McBeth
Healthcare provider reimbursement as a percentage of Medicare fee-for-service rates provides a consistent and well-understood basis for comparing reimbursement rates.
Article
Commercial reimbursement benchmarking
01 November 2022 - by Andy McBeth, Charlie Mills, Danjie Zhou
Provider reimbursement as a percentage of Medicare fee-for-service rates provides a consistent and well-understood basis for comparing reimbursement rates.
Article
Average cost and utilization for audiology, occupational therapy, and speech-language pathology services
09 August 2022 - by Austin Barrington, Deana Bell, Danjie Zhou
We analyze nationwide professional commercial, Medicaid and Medicare claims from 2020 to gauge the average cost and utilization for audiology services.
Article
Commercial Reimbursement Benchmarking: Commercial payment rates for medical services as percentage of Medicare Fee-for-Service rates
01 July 2021 - by Andy McBeth, Charlie Mills, Danjie Zhou
We estimate 2021 commercial reimbursement for medical services to be about 190% of fully-loaded Medicare, with a big difference between facility and professional.