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. Horman Actuarial 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
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