Outcomes analysis is used to determine the efficacy of medical programs. We track and analyze cost and utilization metrics following implementation of plan changes, medical interventions, and other healthcare benefits. Some applications of this type of work include the following:
We perform various forms of actuarial risk adjustment to standardize risk characteristics of members. This has numerous applications for payment, outcomes evaluation, risk assessment, etc...
We have significant experience with Shared Savings Agreements. We provide support creating shared savings contracts, developing shared savings measurement methodologies, assessing the risk of shared savings agreements, and quantifying the outcomes of shared savings contracts/payments.
We help clients better understand the economics of their programs and interventions which can lead to greater levels of efficiency, profit, and decision-making clarity.
We frequently help our clients assess opportunities for their various products and interventions. This often translates into sales support such as building prospect savings models leveraging a prospect's own data. We have seen clients have tremendous success when appropriately applying and leveraging Opportunity Analysis in the sales cycle.
We help startups and the development of new products understand if there is truly financial value within their value proposition. If there is, we help them understand how to better substantiate the defense of that value proposition and sell it to potential buyers
We help clients measure Medical Loss Ratios (MLRs), better understand their loss ratios by different population segments, and improve their MLRs through strategic decision making and interventions
Santa Barbara Actuaries