We have experience in cost and utilization analysis, financial forecasting, value-based program structures, and levers for success in Medicaid, Medicare, and commercial lines of business. We have also developed an analytic system that is both structured (based on our experience with numerous provider groups) and flexible (based on our appreciation that “cookie-cutter” solutions are sub-optimal). This system leverages detailed claims data to develop an ACO profile of the costs, utilization, and disease states of a covered population. This profile can be used to identify outliers, identify opportunities, and target the most critical clinical and cost issues at the ACO practice, provider, or individual member level.
We pride ourselves on knowing a lot – because we have seen a lot. Our staff understands that every ACO is different, with different definitions of success, operational structures, or implement strategies. We work collaboratively with ACOs to translate these insights into useful actionable analysis.
WHAT MAKES THIS VENDOR UNIQUE
- Wakely is a hub of industry-recognized actuarial experts who pool their knowledge and experience. This includes extensive experience with Medicaid and value- based programs with providers and with managed care organizations.
- The value of specialized actuaries collaborating company-wide enables our team to produce great results for clients.
- Our culture of innovation gives each consultant the opportunity to design and implement their own projects and products.
A SUCCESSFUL TA EXPERIENCE
We worked with an ACO that was participating in the CMS sponsored Medicare Shared Savings Program (MSSP). This ACO has been participating in the program since inception and will be up for renewal in 2019. Using their detailed claims data, as well as summary reports provided by CMS, We forecasted the results, while accounting for impacts of changes in assignment methodology, risk adjustment, medical trend, shifting population distribution and revised benchmarking methodology, among numerous other factors. The ACO then used this information, along with our recommendations and pro/con summary of quantitative and qualitative features of the programs to present to their board. This information will help guide their future decision-making, based on their own data with actuarially sound projections.
The statements in this document are made solely by Wakely. No statement in this document should be construed as an official position of or endorsement by Abt Associates Inc. or the Massachusetts Executive Office of Health and Human Services.
Wakely began in 1969 and eventually evolved into several successful divisions. In 1999, the actuarial arm became the current-day Wakely Consulting, which specializes in providing actuarial expertise in the healthcare industry. Consulting services include supporting Medicare, Medicaid, and other government, nonprofit, and commercial providers, and providing broker consulting services. The organization uses their actuarial skills and business experience to help clients understand health care risk drivers and to succeed in their business goals.
ORGANIZATION FUN FACTS
- Staff at Wakely work hard and play hard. Some of the play includes entering running teams in local road races, intra-office ping pong or shuffle board tournaments.
QUOTES FROM CLIENTS
“Wakely provides personal, memorable service. They are top of mind whenever we have questions about trends in healthcare. I am always impressed with the way the Wakely team has of taking really complicated stuff and managing to break it down in a few key slides that are perfect for executive level discussions. Right on point.”