Tim specializes in helping clients assess the risks and financial implications associated with their healthcare products, reimbursement systems, and risk-sharing arrangements. Tim has worked with insurance companies, TRICARE (USFHP), HMOs, PPOs, BCBS plans, and provider organizations for all populations— Commercial, Medicare, Medicaid, and TRICARE populations.
Tim has significant experience in:
Assisting with healthcare benefit plan design, pricing, feasibility studies, and financial modeling
Working with public and private organizations in the cost evaluation of their current and proposed benefit programs
Developing expected utilization and cost benchmarks for commercial, Medicare, and Medicaid populations
Providing regulatory filings for health carriers and projecting healthcare claim reserves
Negotiating rates for USFHP (TRICARE) and Medicaid populations
Negotiating provider contracts
Preparing Medicare Advantage bids
Professional Designations
Fellow, Society of Actuaries (2004)
Member, American Academy of Actuaries
Chairperson, ASOP #50
Member, Health ASOP Committee (2017 to present)
Member, Actuarial Advisory Board, University of California, Santa Barbara
Education
BS, Mathematics and Statistics, Miami University, Oxford, Ohio
15 October 2018 - by Hugh Larson, Annie Man, Tim Wilder, Coleen Young
This paper combines the aggregate gross impact of each of the Next Generation Accountable Care Organizations (NGACOs) shown in the NORC report with the shared savings/(loss) results of each NGACO to calculate the net impact of each individual NGACO.
22 December 2017 - by Hugh Larson, Annie Man, Tim Wilder, Coleen Young
This report identifies several important considerations regarding the impact of the stop-loss provision on participating Next Generation accountable care organizations.
08 November 2017 - by Hugh Larson, Annie Man, Tim Wilder, Coleen Young
For some Next Generation Accountable Care Organizations, the choice between an annual financial reconciliation based upon capped claims or uncapped claims could have a significant impact.
