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Highlights
     

    What We Do

    The healthcare industry faces unprecedented challenges. Confronted by unrelenting, competitive forces in a complex and dynamic market, payers, providers, and regulators must adjust their business practices to address these challenges. We help industry leaders in building and implementing customized actuarial solutions to address the opportunities and challenges they face. 

    Commercial

    As actuarial experts in the ACA and large group markets, we bring state-of-of the art tools and techniques to our commercial market clients, helping to manage the complex, constantly changing state of the market’s competitive landscape. We deliver insights that help our clients build businesses that succeed over the long term. We work with payers to ensure that they are informed of emerging regulatory and competitive risks in this rapidly changing space.

    Medicare Advantage

    We assist Medicare Advantage organizations in developing products and rates to support the strategic specific strengths of their own business model. Our pricing teams employ flexible methods so that clients can implement the products they need to succeed without concern for modeling limitations.

    Provider

    We support providers in identifying and managing risk under new reimbursement arrangements. Because our experience extends across many payers (from Medicare to direct employers) and reimbursement designs (from bundles to capitation), our clients benefit from methods that are tested and empirically based.

    Predictive modeling

    Our team leverages best in class techniques in machine learning to discover breakthroughs and unlock project potential through predictive modeling and advanced analytics. We have extensive expertise in building and implementing predictive models with healthcare payers.

    Regulatory

    We are a trusted partner to insurance regulators, empowering informed decisions that enable impactful actions for their health insurance markets. We provide a comprehensive suite of actuarial services, including reviewing rate filings, helping to enhance rate review processes, studying ways to improve affordability for consumers, and analyzing the expected impact of proposed or passed legislation.

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    What We Think

    Health Insurer Financial Insights, Vol 11

    We present the latest edition of our Health Insurer Financial Pulse newsletter as we continue to operate in unprecedented times.

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    American Rescue Plan Act

    Using actuarial models, we've estimated the impact of ARPA on health coverage if changes to the advance premium tax credits are made permanent.

    Impact of Extending the ARPA Premium Tax Credits Beyond 2022

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    CMS Part D Senior Savings Model

    Considerations for Part D plans on the CMS release of the Part D Senior Savings Model CY2021.

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    Carrier Trend Report - Jul 2022

    Carrier Trend Report - Jul 2022

    A survey of health insurance premiums.

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    Health Plan Profitability Survey 2021

    Oliver Wyman Actuarial surveyed health plan executives to gauge their overall level of concern related to 17 statements that could impact overall health plan profitability in 2021.

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    Solutions

    Conjoin by Oliver Wyman Actuarial is a tool that maximizes profitable demand for specific brands and markets.

     

    We use Conjoin to enable powerful analytics for any potential scenario and be able to know which benefits members prefer in their Medicare Advantage plans.

    Learn About Conjoin
     

    Who We Are