Shalini Prakash

Shalini's work at Milliman includes:

• Leading and expanding the use of CMS’s VRDC data for various client engagements by enabling internal requestors with resources, planning and quality assurance.
• Understanding and fulfilling client analytical needs in the areas of health services utilization, clinical research, healthcare quality and outcomes measurement by providing subject matter expertise.

Prior to Milliman, her experience in government and commercial healthcare agencies included:

• Developed and implemented performance measurement & incentive payment strategy for BH providers
• Led development & implementation of reporting strategy for programs funded by Federal, State, and grants
• Developed measurement plans and performed impact analyses of value-based purchasing programs to demonstrate improved care delivery & cost reduction by Federally Qualified Health Centers, and Critical Access Hospitals
• Developed and implemented clinically actionable quality & financial measures related to maternity care, chronic disease management & Opioid Use Disorder treatment for use in bundled payment models with providers, and for use in MCO contracts
• Built C-level and public facing dashboards and visualizations to inform providers, agency partners, and community organizations of patient outcomes, quality, social determinants of health & finance trends
• Implemented quality measures (HEDIS/NQF/PQA) related to chronic condition care to inform the impact of state and regional programs on quality of clinical care, equity and profiled poor performing accountable entities
• Built data capacity & served as data lead within state government health agency for federal grants and state legislature directed initiatives
• Developed custom pricing models for company’s pilot programs based on their scope and effectiveness like medication therapy management, fraud waste, & abuse.
• Developed budget impact models & tools to quantify client cost impact resulting from regulatory (Affordable Care Act) and market changes
• Evaluated the clinical and economic value of innovative workplace on-site pharmacies, limited formularies, physician, and consumer targeted healthcare utilization management programs