Webinar

Milliman webinar series: Direct Contracting

CMMI’s Direct Contracting model: Participation primer

Starting in CY2021, the Center for Medicare and Medicaid Innovation (CMMI) will be operating a new total cost of care model for Medicare FFS beneficiaries called Direct Contracting (DC). It is loosely modeled on CMMI’s Next Generation ACO model as well as the Center for Medicare and Medicaid Services’ (CMS’s) Medicare Shared Savings Program (MSSP). While this model widens the horizons of what types of organizations may participate in this program (including health insurers and provider groups, among others), it is essential that potential participants understand the risks and opportunities that this model presents.

Join ACO consulting experts from Milliman (currently working with 70+ ACOs) for a discussion of the general framework of the DC model, a history of the various ACO programs, and a discussion of how participants can leverage their current provider relationships, care management infrastructure, and Milliman resources in order to succeed in this new program. Milliman will also be sharing a demonstration of their Portfolio Contract Intelligence (PCI) solution which allows entities to holistically track and monitor their portfolio of risk-based contracts (including MSSP and DC) and help understand how each of those contracts contribute to an entities overall revenue stream.

Presenters:

Jonah Broulette, ASA, MAAA
Senior Healthcare Analytics Consultant and Associate Actuary, Milliman

Noah Champagne, FSA, MAAA
Consulting Actuary, Milliman

John Hanaway
Product Manager, MedInsight Product Marketing, MedInsight

Direct Primary Care: A unique healthcare solution for employers - Background, key benefit considerations, industry offerings, and analytic challenges

The Direct Primary Care (DPC) practice model is relatively new and still evolving; there is no single definition of what constitutes a DPC practice. In 2020, the Society of Actuaries commissioned Milliman to develop a study characterizing the DPC model and evaluating certain claims made about its effectiveness. As the DPC model continues to grow, there are an increasing number of DPC point solutions available to employers self-funding their medical benefits. Join Everside Health, Hamilton Health Box, and Milliman for a discussion on DPC. We will provide background on the DPC model, cover key considerations for employers considering a DPC offering, and learn about two specific DPC offerings in the marketplace.

Presenters:

Kirk Rosin
Chief Revenue Officer, Everside Health

Adrian Tromel, MBA
VP of Strategy, Hamilton Health Box

Dustin Grzeskowiak, FSA, MAAA
Consulting Actuary, Milliman

Private direct contracting: Evaluating opportunities for employers and providers to achieve better healthcare outcomes

For employers sponsoring health insurance benefits for their employees, maintaining competitive benefits packages is key to attracting and retaining top talent. And in the face of perpetual medical and prescription drug trends, employers are seeking out directing contracting strategies that would allow them to maintain competitive benefits, while also reducing costs and enhancing employee satisfaction.

For provider organizations pursuing the ‘Quadruple Aim’, establishing direct contracts with employers presents opportunities to leverage their population health investments across larger patient bases and receive compensation for efficiency and value. The current climate of price transparency further serves as a catalyst for inducing employer demand for direct contracts.

Join us to hear our consulting actuaries explore direct contracting strategies from both employers’ and provider organizations’ perspectives, including motivations and challenges associated with various strategies. Our product leadership will also explore opportunities to leverage MedInsight’s advanced analytics to facilitate successful outcomes.

Presenters:

Mike Gaal, FSA, MAAA
Principal, Consulting Actuary, Milliman

Brian Sweatman, FSA, MAAA
Consulting Actuary, Milliman

Marcos Dachary
Principal, SVP of Sales and Growth, Milliman, MedInsight

Barb Ward
Director, Sales Operations, Milliman, MedInsight

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