Simon Moody

Simon has more than 20 years of experience working with health provider organizations, insurers, CMS, and a variety of other organizations. He has significant experience working with providers and payers in the design, evaluation, audit, and performance monitoring of various population-based reimbursement agreements. He also works with a number of health systems and ACOs to design and implement internal distribution models. Simon has extensive Medicare Advantage expertise, including, assisting health plans with CMS regulatory filings.

His specific areas of expertise include:

• Development, actuarial modeling, and negotiation of payer-provider contracts, including population-based and shared-risk reimbursement, narrow network offerings, and CMS payment models
• Development of internal models for distributing payments from population-based payment contracts across provider networks
• Population and utilization demand modeling for healthcare provider systems
• Medicare Advantage bid development and certification, feasibility studies, and associated services