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Susan Pantely

FSA, MAAA
Principal, Consulting Actuary
San Francisco, CA, US

Susan Pantely is a principal and consulting actuary with Milliman's Health Practice. She is located in San Francisco, California, and Pittsburgh, Pennsylvania, and joined the firm in 1988.

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Experience

Susan provides actuarial and consulting services to a broad range of clients, including Blue Cross/Blue Shield plans, HMOs, commercial insurers, government agencies, and healthcare providers. Her work includes rate development, provider contract review, reserve certification, capitation development, Medicare risk feasibility studies, HMO start-ups, HMO due diligence, and development of risk sharing and reimbursement arrangements for physician groups, PHOs, ACOs, and other integrated delivery systems.

In addition, Susan has extensive experience with the valuation, financial analysis, and projection of healthcare services for several state public health insurance (Medicaid) programs.

Publications and Presentations
  • "Social Determinants of Health," Co-Author. Contingencies Magazine (American Academy of Actuaries), June 2020.
  • "Healthy Adult Opportunity: CMS Guidance Details New Medicaid Program Reform Options for All States," Co-Author. Milliman White Paper, February 2020.
  • Telehealth – A Digital Communication Approach to Improving Health, Co‑Presenter. American Academy of Actuaries Capitol Hill Briefing, September 2019.
  • "Patient-Centered Medical Home: Developing the Business Case from a Practice Perspective," Co-Author. Milliman White Paper submitted to National Committee for Quality Assurance (NCQA), June 2019.
  • Utilizing Metrics to Identify High Risk Patients and Other Analytic Tools to Reduce Readmissions. Presentation for 2019 Reducing Hospital Readmissions Summit, June 2019.
  • "Whose Patient Is It? Patient Attribution in ACOs." Milliman Healthcare Reform Briefing Paper, January 2011.
  • Medicaid Program Redesign: The Long Term Care and Developmentally Disabled Programs (report for Wyoming Health Care Commission, September 2006, co-author).

Professional Designations

  • Fellow, Society of Actuaries
  • Member, American Academy of Actuaries

Education

  • BS, Mathematics, University of Pittsburgh
Affiliations
  • Member, American Academy of Actuaries’ Health Practice Council
  • Former vice president, Board of Directors, Society of Actuaries
  • Member, Society of Actuaries’ Education and Examination Committee
  • Member, American Academy of Actuaries’ Health Care Quality Workgroup
  • Member, American Academy of Actuaries’ Medicaid Workgroup
  • Former chair, Society of Actuaries’ Health Section Council

Publications

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