Peter’s core areas of focus are Affordable Care Act (ACA) pricing, commercial risk adjustment, and provider shared savings arrangements. He also has experience with predictive analytics and data science.
Examples of Peter’s expertise include the following:
- Assisting health plans in several states to prepare individual and small group strategy, pricing, and rate filings
- Working with ACA carriers to complete accurate EDGE server submissions and improve risk adjustment operations
- Developing internal models for risk adjustment analytics, coding improvement, and EDGE server submissions
- Identifying potentially undercoded or overcoded members to optimize risk coding for health plans
- Evaluating provider-shared savings arrangements, reimbursement benchmarking, and projecting claim costs
