Medicare Advantage,
Part C & Part D for MAOs
MLTC, Medicaid, and CHIP
Commercial Health Coverage
Medicare Advantage, Part C & Part D for MAOs
Acumen provides services ranging from strategic advisory to hand-on development and certification of BPTs and bids for Medicare Advantage Organizations. We work with all types of MAOs on all manner of MA-PD bids—individual and group, including all types of special needs plan (SNPs) and Medicare-Medicaid MLTC. Acumen has worked with Dual SNPs, Institutional SNPs, and Chronic Needs SNPs. Acumen also provides review and support services for clients that develop their own bids internally. Acumen also shows MAOs how to bring that bid development capacity in house. Acumen assists MAOs with portfolio and plan design as well as other aspects of product development such as driving profitable growth. Acumen understands the drivers of success in Medicare Advantage and other government programs. We have assisted MAOs in the development of their own analytics to monitor and manage performance. And we help MAOs to drive revenue growth and manage expenses. Acumen has provided support and training around PBP development and other aspects of MA-PD. Acumen works with PBMs and other participants in the bid process.
Acumen has worked with PACE programs and similar programs for special needs populations such as those with HIV, mobility challenges, and intellectual disabilities. Acumen understands social HMOs and non-profit organizations that provide care to the underserved and other high-cost special populations.
Acumen provides a review of the existing line of business for MAOs. We determine strengths weaknesses, opportunities and threat within the MAO’s service area and market space. This review is tailored to the client to address their specific needs, capabilities, and markets. It is an independent assessment of the MAO and its MA-PD product line.
MLTC, Medicaid, and CHIP
Acumen has worked on managed long term care programs as well Medicaid and the Children’s Health Insurance program. These vary from state to state. Acumen has provided specialized actuarial consulting services to companies in this space. Acumen understands social HMOs and non-profit organizations that provide care to the underserved and other high-cost special populations. Acumen works on issues involving actuarially sound pricing.
Commercial Health Coverage
Acumen provides consulting services related to fully insured and self-funded commercial health coverage. Acumen has extensive experience in commercial coverage of all types, for groups of all sizes and “individual” coverage. In the self-funded arena, Acumen has worked with medical stop loss, both Specific and Aggregate. Acumen also has experience with dental and pharmacy benefits and can advise clients in these areas. Acumen assists clients with a full-range of health actuarial consulting services from pricing and product design through valuation and reserving.