Health Plan Provider Network Risk

Research Projects in Health


The Health Section Research Team is pleased to make available the following research study and Excel model that provide a framework for estimating the financial impact of health plan provider network risk. The research was conducted by the Denver office of Milliman, Inc. The Excel workbook allows the user to assess cost implications of aspects of network risk under various assumptions. The assumptions in the workbook can be altered by the user and be applied to test a range of scenarios. In addition, the workbook has been protected without a password. A password was intentionally not used to protect the workbook in order to allow a user to alter the underlying structure of the workbook or incorporate additional assumptions to suit a particular user’s needs. Users are encouraged to report any new areas of data availability or advancements in the model structure that they think would further knowledge in this area.

Acknowledgements

The research team from Milliman consisted of Ross Winkelman, Jill Van Den Bos and Craig Johns.

The SOA would like to thank the following members of Project Oversight Group for their valuable contribution.

  • Trevor Pollitt, Chair
  • Tim Adams
  • Randy Edwards
  • John Stark
  • Steve Siegel, SOA Staff
  • Jeanne Nallon, SOA Staff