Health Care Reform Consultants Wakely Consulting Group Inc. Releases Free Open Source Risk Assessment Model for Commercial Populations

Share Article

Comprehensive tool modifies Medicare and Medicaid models to include the cost, treatment patterns and pharmacy utilization that occur within commercial populations.

Wakely Consulting Group Inc., a national actuarial and healthcare reform consulting firm, announced the release of version 1.01 of the Wakely Risk Assessment (WRA) model. This model was developed to provide a transparent, high-performing, completely free and open-source risk assessment model for a commercial population.

The lead developer, Syed Mehmud, Consulting Actuary for Wakely Consulting Group, commented that “The health care industry needed a free, open source commercial model because the Federal risk assessment model will not be ready until late fall 2012 and no similar model now exists. While states may decide to use the WRA model as a state alternative, its primary purpose is a bridge to the Federal model.”

The WRA model was developed using the widely used Centers for Medicare and Medicaid Services’ Hierarchical Condition Category (CMS-HCC) model as the starting point. The CMS-HCC model was modified to account for the unique characteristics of a commercial population. The model uses diagnosis data and/or pharmacy data.

The WRA model is available for download at http://www.WRAModel.com. A detailed white paper on this model is also available on this site.

States have the option to use the Federal risk adjustment methodology, which would be released towards the end of this year, or to pursue an alternative methodology. For states that wish to decide on an alternative, the timing is crucial and the WRA model may be useful in evaluating available data and the feasibility of a state-alternative methodology. In addition, health plans require information on expected results of a risk adjustment mechanism in order to inform actuarial pricing for 2014. Wakely Consulting Group has prepared a detailed work plan for state officials that has been released by the Robert Wood Johnson State Health Reform Assistance Network. That report is available for download at http://www.wakely.com/3Rs-WorkplanforStates.pdf.

About Wakely Consulting Group Inc. http://Wakely.com/content.htm
Wakely Consulting Group is a nationally-recognized health care actuarial consulting firm serving nationwide health plans, insurance companies, government regulators, employers, healthcare providers and other stake-holders in health care, managed care and health care reform markets. Wakely Consulting Group assists clients with product pricing/premium development, feasibility studies, predictive modeling, actuarial certifications and filings, operational analysis, compliance, and other financial and management aspects of their business. Wakely Consulting Group is headquartered in Clearwater, FL, with additional offices in Denver, CO; Louisville, KY and Boston, MA.

###

Share article on social media or email:

View article via:

Pdf Print

Contact Author

Syed Mehmud - ASA, MAAA, FCA

Ross Winkelman - FSA, MAAA
Visit website