Actuarial and Financial

Actuarial and Financial

HMA’s approach to providing Accountable Care Organizations (ACOs) and Community Partners (CPs) with technical assistance in the Actuarial and Financial Domain will build on our extensive experience supporting providers who are moving to alternative or risk-based payment models.

Recognizing the range of strategic and operational work that providers need to undertake to succeed in a risk-based environment, HMA has developed a Value-Based Payment Readiness Assessment Tool that is designed to help provider organizations systematically assess their capacity to engage in risk- and quality-based payment models and identify gaps to address in eight specific domains of organizational readiness.

HMA and our Actuarial and Financial Domain Team members have also worked with providers in Massachusetts and across the country to address specific financial and actuarial issues, including developing a financial funds flow model and identifying strategies to improve integration with behavioral health services. Members of our Domain Team have also worked with a variety of states and payer clients to design the elements of a value-based payment (VBP) model, including developing shared savings models, designing strategies for including quality in VBP models, setting capitation rates, analyzing how social determinants affect risk and payment, and creating all-payer approaches to financing a delivery system reform model.

For more information, contact MassHealthTAvendor@healthmanagement.com

Meet Our Team

The HMA Actuarial and Financial Domain Team, which is led by Tom Dehner, includes local and national experts with experience supporting the financial and actuarial needs of provider organizations as they move into an accountable care environment.

Ellen Breslin MPP

Principal
Boston, MA

Tom Dehner JD

Managing Principal
Boston, MA

Art Jones MD

Principal
Chicago, IL

Myra Sessions, MS MS

Senior Consultant
Boston, MA

Lisa Whittemore MSW, MPH

Principal
Boston, MA

View Our Recent Work

Massachusetts League of Community Health Centers: Value-Based Payment Technical Assistance

  • Project Challenge or Goals: Educate and support association members with site-specific TA
  • Project Period: September 2016 – October 2017 (for primary scope of work; project remains active)
  • Project Description: A technical assistance contract supporting member CHCs to plan for and succeed under the Massachusetts ACO framework
  • Project Achievements: HMA provided a one-day conference focusing on readiness for VBP and Massachusetts ACO models, and has provided a series of Learning Collaboratives for health center leadership and staff on strategies to succeed in a value-based payment environment. Learning Collaboratives have focused on aggregate gaps identified using HMA’s Value-Based Readiness Assessment tool completed by 22 health centers

Strategic and Operational Planning Support for Massachusetts CHC

  • Project Challenge or Goals: Assist a multi-site CHC in achieving readiness for MassHealth ACO program
  • Project Period: January 2016 – January 2017 (for primary scope of work; project remains active)
  • Project Description: A contract to improve MCHC’s readiness to accept Alternative Payment Methods, focusing on both its clinical and financial processes, data and analytics capabilities, and associated required workflow and related information system changes
  • Project Achievements: HMA provided an evaluation of the current environment, a gap analysis, and support for the implementation of an approved work plan

Association of Behavioral Health: VBP Conference

  • Project Challenge or Goals: Educate and support association members about ACOs, DSRIP and VBP
  • Project Period: July – September 2016
  • Project Description: A contract to plan, orchestrate, and provide substantive content for a one-day technical assistance conference for member behavioral health providers concerning ACOs and the role of behavioral health in value-based payment
  • Project Achievements: HMA produced a well-reviewed one-day conference with accompanying fact sheets