Are you underwhelmed by the quarterly and annual reports produced by your health insurance broker, provider network, TPA/ASO contractor, PBM, and wellness and care management vendors? We are. We work for you to find specific actionable hot spots of over-pricing, ineffective interventions, fraud, waste, and abuse – the things that cause you to spend more than you should.
Do you need help preparing a health policy analysis or responding to someone else’s analysis? We perform careful, documented analyses and clearly articulate the strengths and weaknesses of our findings, in the format that suits your needs.
Is risk adjustment a black box? We will help you unbox it! We are experts at risk adjustment, from the philosophical to the technical. We have rewritten the SAS risk adjustment scripts distributed by CMS into R.
Do the technical descriptions for member attribution models, incurred and paid claims, risk adjustment, and quality of care measurements make your eyes roll? You are not alone. Dr. Sawhney, an actuary, however, is really into these topics.
