Value-Based Payment Insights and Support for Providers
What Your Organization Needs to Succeed in Risk-Based Arrangements
Wakely, an HMA Company, partners with providers across the healthcare landscape — from Medicare Advantage and MSSP to ACO REACH, commercial, and Medicaid value-based programs. Our experts provide comprehensive analytical, actuarial, and financial support to help organizations thrive in value-based arrangements.
We publish quarterly updates featuring actionable strategies, regulatory developments, and data-driven perspectives to help providers succeed in today’s evolving value-based landscape.
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Rethinking Downside Risk: The Role of Stop Loss in ACO Contracts
ACO Risk Mitigation Strategies: Part 1
Wakely’s new white paper, Rethinking Downside Risk: The Role of Stop Loss in ACO Contracts, helps accountable care organizations (ACOs), provider groups, and value-based care leaders evaluate how to manage downside risk in Medicare Shared Savings Program (MSSP) and CMS Innovation Center LEAD Model contracts. The first installment in Wakely’s ACO Risk Mitigation Strategies series, developed with Josh Gottesman of Brown & Brown, explains how aggregate stop loss, member-level stop loss reinsurance, and disciplined actuarial projection can help ACOs cap repayment exposure, support CMS financial guarantee requirements, protect the balance sheet, and retain more shared savings instead of giving away upside to an enabler or aggregator. For organizations preparing for two-sided risk, the paper offers practical guidance on quantifying repayment risk, comparing stop loss structures across MSSP and LEAD, and aligning actuarial analysis with broker market strategy.
