John assists clients with a variety of projects, many focused on healthcare reform, provider contracting, rating and underwriting, and Medicare Advantage. Examples of the work John does include:
- Healthcare reform strategies for health plans, hospitals, and clinics
- All-purpose actuarial expertise for regional provider-affiliated health plans
- Underwriting approaches and premium rate development for large group, small group, and individual business
- Commercial provider contract payment level comparisons for both health plans and hospitals using a variety of data sources
- Claims experience analysis, benchmarking, and reporting
- Developing commercial and Medicare Advantage group underwriting models and processes
- Medicare Advantage bid development and strategies
- Working with providers to understand and negotiate ACO risk-sharing provisions
- Contract parity evaluations between commercial health plans and hospitals/physician groups
- Managed Medicaid bid development
- Review underwriting approaches versus best practices
- Review provider contracting approaches versus best practices
