As the movement toward value based contracting continues to intensify, there are more variables to consider than ever — including shared risk/savings relationships, episodic payments, increased provider/regulatory reporting, and the need to guard against unforeseen consequences. HMA Solutions has both the wide-range perspective and issue-specific expertise to help you navigate this complex and changing environment.
Advanced provider-side actuarial consulting:
Experience Analysis & Forecasting
- In-depth analysis of mined claims data
- Forecasting trends for risk payments, reimbursements, etc.
Actuarial Model Consulting
- Risk adjustment consulting
- Analysis and advice for alternative payment models
Rating Strategy, Filing & Support
- Developing factor/trend analyses for rate increase requests
- In-person support for communications and meetings with DOIs
Strategic Contract Design & Pricing
- Provider/network design for fee schedules and capitation rates
- Negotiation assistance for con-tract pricing, terms, and coverage