Maggie Alston

Principal

New York, NY, US

Maggie Alston is a principal based in New York. She joined Milliman in 2015.

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Experience

Maggie has an extensive background in healthcare data analytics. She has worked with traditional and nontraditional healthcare data sources to build population identification and bundled payment algorithms, and is an expert in developing dynamic, illustrative data models.

Maggie also has experience in developing shared risk arrangements between payers and providers and between payers and pharmaceutical companies.

Prior to joining Milliman, Maggie worked as a technical lead, developing patient identification and treatment algorithms for a population health technology start-up. Maggie also previously worked for a large medical group in compliance and patient satisfaction analytics.

Publications and Presentations

A Comparative Retrospective Analysis of Comorbidities Potentially Sensitive to Corticosteroid Exposure between Incident COPD and Overall Medicare Populations. 2021 AMCP Nexus Conference Poster. October 2021. Denver, CO.
The Complexity of Medicare's Pharmacy Benefit Structure in a Budget Impact Model. 2021 ISPOR Annual Conference Poster. May 2021.
Treatment patterns for patients with CAR T-indicated lymphoma diagnoses receiving third or later-line therapy. Commissioned by Gilead Sciences, Inc. Published on milliman.com. December 2020.
Strategic Use of Post-Market Real World Evidence to Demonstrate Value. 2019 MedTech Conference. October 2019. Boston, MA.
Risk Contracting: A New Path to Partnering with Customers. 2019 IDN Summit and Reverse Expo. September 2019. Phoenix, AZ.
Applying Machine Learning Techniques to Identify Undiagnosed Patients with Exocrine Pancreatic Insufficiency. Commissioned by AbbVie. Published by Journal of Health Economics and Outcomes Research. February 2019.
Changing the rebate game: A primer on the HHS proposed rule to shift drug rebates to POS. Published on milliman.com. February 2019.
Breaking though the hype of real world evidence. Published on milliman.com. January 2019.
Pharma APMs: A learning curve awaits you, pharma. Commissioned by PhRMA. Published by Managed Care. October 2018.
Pharma APMs: Can the industry learn to play well with others? Commissioned by PhRMA. Published by Managed Care. September 2018.
Alternative payment model financial settlements: Preparing for and learning from the process. Published on milliman.com. September 2018.
A primer on prescription drug rebates: Insights into why rebates are a target for reducing prices. Published on milliman.com. May 2018.
Serious Contracts Come with Risk, but Alternative Payment Models are Here to Stay. 2018 AMCP Nexus Conference. September 2018. Orlando, FL.
Pharmaceutical Value-Based Contracting. SOA Health Section Medicaid Subgroup. March 2018.
Value-Based Contracting for Pharmaceutical and Device Manufacturers. 2017 SOA Annual Meeting. September 2017. Boston, MA.

Professional Designations

Maggie is a Certified Healthcare Finance Professional with the Healthcare Financial Management Association.

Education

BA, Public Policy Analysis – Biology, Scripps College

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Publications

Read their latest work

Article

4 key takeaways from the third round of drugs selected for Medicare drug price negotiation

20 February 2026 - by Maggie Alston, Massey Whorley, Stephanie Leary, Isabelle Creavin

The Centers for Medicare and Medicaid Services announced the list of drugs selected for price negotiation for 2028. We broke down the implications.

Article

The CMS Transforming Episode Accountability Model: 4 reasons why it’s an opportunity for skilled nursing facilities to partner with hospitals—and 3 steps for developing a TEAM strategy

05 February 2026 - by Alyssa Pennini, Maggie Alston, Kate Fitch

We show how SNFs can proactively engage with hospitals, given their mandatory participation in a new model by the Centers for Medicare and Medicaid Services.

Video

FDA in flux: Leadership, policy, and the road ahead

04 September 2025 - by Maggie Alston, Rebecca Smith, Jeff Garbe, Alison Falb

The FDA’s landscape is shifting rapidly with leadership changes, staff reductions, and evolving policy priorities.

Article

The next generation of Medicare bundled payments: Considerations regarding TEAM

03 September 2025 - by Alyssa Pennini, Christopher Murphy, Maggie Alston, Noah Champagne, Pamela M. Pelizzari

The Transforming Episode Accountability Model, Medicare’s new approach for bundled payments, will impact a wide variety of acute care hospitals nationwide.

Article

3 reasons life sciences companies need strategies for engaging with ACOs

22 August 2025 - by Kate Fitch, Maggie Alston

This listicle reviews three reasons why life sciences companies need a strategy for engaging with ACOs, such as the increasing use of value-based-care arrangements.

Article

Bleeding-related hospitalizations among direct oral anticoagulant users and nonusers in Medicare fee-for-service

22 July 2025 - by Carol Bazell, Maggie Alston, Stephanie Leary, Winston Fopalan, Latha Ganti, Raymond Chang, H. Andrew Wilsey, Christopher Baugh

Among Medicare fee-for-service members, we found the bleeding-related hospitalization rate was four times higher for users of direct oral anticoagulants.

Article

Beyond FDA approval: 5 factors in clinical trial design that influence health insurance coverage decisions

03 June 2025 - by Maggie Alston, Rebecca Smith

We detail factors in Phase-3 clinical trial design that influence health insurance coverage decisions.

Article

Variation in prevalence and burden of chronic obstructive pulmonary disease by state and insurance type in the United States

26 February 2025 - by Carol Bazell, Maggie Alston, Norbert Feigler, Hayley Germack, Stephanie Leary, Winston Fopalan, David Mannino

Our research on COPD populations shows wide variations in prevalence and burden of disease, depending on the U.S. state and patient insurance type.

Video

2025 Medicare Bid Cycle: Life Sciences Insights

31 July 2024 - by Matthew Hayes, Peter Heinen, Ryan Swenson, Maggie Alston

Milliman’s actuarial experts discuss Part D lessons from the latest bid cycle and the impact on life sciences organizations.

Article

Shadow bundles: A big opportunity for MSSP and REACH ACOs

13 February 2024 - by Maggie Alston, Noah Champagne, Daniel DiNinno, Emma Kramer, Christopher Murphy

New data for the Medicare Shared Savings Program and ACO REACH models provide opportunities for managing referrals, but ACOs should know the data’s limitations.

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Experience

Maggie also has experience in developing shared risk arrangements between payers and providers and between payers and pharmaceutical companies.

Maggie Alston

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Experience

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Read their latest work

4 key takeaways from the third round of drugs selected for Medicare drug price negotiation

The CMS Transforming Episode Accountability Model: 4 reasons why it’s an opportunity for skilled nursing facilities to partner with hospitals—and 3 steps for developing a TEAM strategy

FDA in flux: Leadership, policy, and the road ahead

The next generation of Medicare bundled payments: Considerations regarding TEAM

3 reasons life sciences companies need strategies for engaging with ACOs

Bleeding-related hospitalizations among direct oral anticoagulant users and nonusers in Medicare fee-for-service

Beyond FDA approval: 5 factors in clinical trial design that influence health insurance coverage decisions

Variation in prevalence and burden of chronic obstructive pulmonary disease by state and insurance type in the United States

2025 Medicare Bid Cycle: Life Sciences Insights

Shadow bundles: A big opportunity for MSSP and REACH ACOs

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CHOOSE A LOCATION AND LANGUAGE

Maggie Alston

Experience

Read their latest work

4 key takeaways from the third round of drugs selected for Medicare drug price negotiation

The CMS Transforming Episode Accountability Model: 4 reasons why it’s an opportunity for skilled nursing facilities to partner with hospitals—and 3 steps for developing a TEAM strategy

FDA in flux: Leadership, policy, and the road ahead

The next generation of Medicare bundled payments: Considerations regarding TEAM

3 reasons life sciences companies need strategies for engaging with ACOs

Bleeding-related hospitalizations among direct oral anticoagulant users and nonusers in Medicare fee-for-service

Beyond FDA approval: 5 factors in clinical trial design that influence health insurance coverage decisions

Variation in prevalence and burden of chronic obstructive pulmonary disease by state and insurance type in the United States

2025 Medicare Bid Cycle: Life Sciences Insights

Shadow bundles: A big opportunity for MSSP and REACH ACOs

CHOOSE A LOCATION AND LANGUAGE