Medicare Advantage
Our consultants = your advantage in the Medicare Advantage market.
In the complex Medicare Advantage (MA) market, the competitive advantage goes to the health plan or provider with the clearest view of what needs to be done. Wakely consultants and expert actuaries have years of experience dealing with the MA market and closely monitor policy and regulatory developments to keep our clients up to date. Through strategic advice, analytics, proprietary tools, and comprehensive market data, we give you the edge you need to succeed.
Wakely’s Medicare Advantage Services
Our experts can assist you with:
- Medicare Bid Preparation, including bids for prescription drug plans, special needs plans, HMOs, PPOs, and POS plans
- Part D Reconciliation, including risk corridor settlement projection and LICS/CGDP/federal reinsurance settlements
- Bid, Risk Adjustment Data Validation (RADV), and One-Third Financial Audit Support
- Pharmacy Benefit Manager (PBM) RFP Analysis, including design of RFPs and evaluation of the cost impact of PBM proposals
- MA benchmarking, including utilization and costs by service category
- Market feasibility, including projected results for expansions of a plan’s service area and for startup plans
- Certificate of Authority (COA) filing, including pro-forma preparation and actuarial certification of COA filings
- Risk score accrual estimates, including projected impact of mid-year, final sweeps, and encounter data submission completion
- Provider reimbursement evaluation, including cost impact of fee schedules, risk-sharing arrangements, and value-based contracts
We back your strategies with a wealth of data.
Wakely consultants draw on a broad range of data sources to assist you in market analysis, benchmark development, strategy and more. Here are just a few:
- Medicare 100% Research Identifiable File
- Medicare Limited Data
- Wakely Medicare Advantage Aggregate Client Data
- Wakely ACA
- Large Group Commercial Data
Ready to connect with a Wakely expert?
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