Adam has over 20 years of experience in the healthcare industry, primarily working with healthcare providers, ACOs, managed care organizations, and employer sponsored insurance plans. He has significant experience working with healthcare providers in negotiating and supporting value-based payment models, optimizing reimbursement, developing narrow network products, performing utilization and cost benchmarking, conducting financial reporting, and developing population health management strategies.
Adam has assisted public and private employers with services such as reserving, premium rate development, COBRA rate development, budget projections, RDS attestation, Medicare Part D creditable coverage testing, GASB retiree medical projections, and long-term sustainability strategy.
His specific areas of expertise include:
- Development, actuarial modeling, and negotiation of payer-provider contracts, including population-based and shared-risk reimbursement, narrow network offerings, and CMS payment models
- Value-based payment reporting and settlement projections
- Audit and validation of value-based payment settlements
- Optimization of provider reimbursements
- Premium rate setting, reserving, and budgeting for employer-sponsored benefit plans
