Addressing the needs of evolving healthcare exchanges for commercial and government plans
Healthcare Providers
Helping to address ACA-driven needs for intensified risk modeling, episodic payments, reporting and plan / contracts design.
Commercial Health Plans
All facets of commercial health plan consulting. Including reserving / rating and exchange strategies for product design and filing.
Government Plans
From Medicare / Medicaid bid support and rate evaluation to product design, network configuration and provider risk models.
Reserving and corporate actuarial functions.
Along with traditional reserving work — including IBNR, PDR and other major actuarial accruals — HMA Solutions performs budget forecasting and financial monitoring. We are also qualified to sign annual statements of actuarial opinion.
Modeling tools, systems and processes
Aligning populations, projections and profitability
News and Industry Observations
2021 Updates to Mental Health Parity Testing Requirements
The Consolidated Appropriations Act, 2021 (more here) amended The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) to require group health plans [...]
An Overview of the Biden Plan to Protect and Build on the ACA
President-Elect Joe Biden has a new health insurance plan for America once he is inaugurated as President on January 20th. He plans to build on the existing Affordable Care [...]
COVID-19: OCR Issues New HIPAA Guidance for Contacting Recovered Patients
The United States Department of Health and Human Services Office for Civil Rights (OCR) issued updated guidance regarding contacting former COVID-19 positive patients about blood plasma donation, as related [...]