Alan serves a variety of clients, including health plans, ACOs, and health systems. His primary areas of focus include alternative payment models and risk sharing arrangements, including supporting organizations in Medicare ACO programs (MSSP, Direct Contracting, and NextGen ACO). Alan supports both payors and providers in these models, including assisting payors with the design, implementation, and ongoing administration of commercial shared risk arrangements and episodic payment models.
In addition to his work on alternative payment models, Alan also has expertise supporting organizations with risk adjustment analytics. This work includes EDGE server data submissions for ACA health plans and suspect analytics for coding accuracy initiatives for payors and providers in ACA, Medicare Advantage, Medicare ACO, and Medicaid Managed Care programs.
Examples of recent engagements include:
- Evaluation of Medicare ACO strategy and program participation options
- Financial management and provider analytics for Direct Contracting Entities in the Global and Professional Direct Contracting Program
- Design and implementation of shared risk arrangements for health plan and provider clients
- Financial analytics and strategic assistance supporting the negotiation of episodic payment models
- Provider contracting and reimbursement analyses, including claims repricing
- Health plan financial monitoring, including development and deployment of executive-level reporting
- Support of EDGE data submissions, including analytics to identify errors driving missed risk adjustment value
- Coding accuracy analytics to find and prioritize both under- and over-coded claims
