What We Do
We assist Medicare Advantage organizations to strategically develop products and rates to align with the specific strengths of their own business model. Our pricing teams employ flexible modeling methods allowing clients to implement the products they need to succeed. We partner with organizations beyond the pricing process to provide creative solutions to unique problems and ensure our clients optimize their market position while mitigating downside risk.
Feasability studies, market entrance assistance, and pro forma development aligning with payer’s strengths
Product design, including consumer survey driven product feature prioritization, maximizing member growth while minimizing margin impact
Transparent and iterative pricing process that culminates in filing CMS BPTs, desk review, and audit
Employer group pricing including Medicare Supp to MAPD conversions and RFP response strategy
Risk Score optimization and accruals, including identification and stratification of opportunity
Advise on total cost of care management including UM, CM, and DM design through benchmarking, ROI optimization, and market assessment
Part D settlement and premium deficiency reserve estimates to provide insight into future receivables or payables Consulting Actuaries
We don’t just provide service to Medicare Advantage organizations. We are strategic partners that help them take care of their people while also achieving ultimate business goals.
Critical steps in a Medicare Advantage client partnership
We begin by assessing where the business currently sits in the marketplace and determining profitability by product type.
Then we evaluate the client’s own goals and consider the future strategic position of their products.
Finally, we develop shared assumptions and approaches, while leveraging a robust set of adaptable tools which help achieve both a competitive and profitable product.
