Brian primarily consults with providers, commercial insurers, and large employers. His client activities include:
Value-based payment model strategy, design, and pricing (including bundled payments, shared savings/risk arrangements, capitation, and joint ventures)
Population health analytics
Utilization and cost benchmarking
Fee schedule analysis
Custom network design and pricing
Healthcare cost analysis
Preparation of commercial regulatory rate filings for both ACA and non-ACA products, including individual and group
Pricing and rate development
Alternative payment model support
Analysis of actuarial liabilities
Prior to joining Milliman, Brian was an analyst with Coventry Health Care and previously worked with AonHewitt.
Publications and Presentations
How will EDGE affect your 2019 ACA Risk Adjustment Transfer? (Published on milliman.com, August 2018).
"Pathways to Success" MSSP proposed rule: Integrity (published on milliman.com, November 2018).
Value-Based Payment Models - Actuarial Considerations (Southeastern Actuaries Conference Fall Meeting, Nashville, TN, November 2018).
Considering trend guarantees in your next TPA selection analysis (published on milliman.com, May 2019).
Direct contracting strategies for employers (published on milliman.com, May 2020).
Ten questions providers should be asking about their value-based contracts and the COVID-19 pandemic (published on milliman.com, May 2020).
Direct Contracting and Other Models: How CMS, Providers, and Employers Continue to Challenge the Status Quo (Society of Actuaries Virtual Health Meeting, June 2020).
Payer-Provider Collaboration: The Road Behind, The Road Ahead (Conference of Consulting Actuaries Webinar, June 2021).
Professional Designations
Fellow, Society of Actuaries
Member, American Academy of Actuaries
Education
BBA, Actuarial Science, Georgia State University
Executive MBA, Quantic School of Business & Technology
27 March 2023 - by Carol Bazell, Maggie Alston, Pamela M. Pelizzari, Brian A. Sweatman
With the CMS, Medicare Advantage organizations, Medicaid organizations, and health plans experimenting with bundled payments, we offer a primer and perspectives.
19 May 2020 - by Cory Gusland, Anders Larson, Brian A. Sweatman
For any given provider organization, the impact of COVID-19 on its value-based contracts will depend largely on certain actuarial, legal, and strategic aspects of each agreement.
This paper summarizes a few direct contracting strategies observed in the marketplace and identifies key areas for considerations as employers evaluate these options.
01 May 2019 - by Scott Cohen, Paul Sakhrani, Brian A. Sweatman
There is increased interest from both employers and third-party administrators (TPAs) in incorporating medical trend guarantees into TPA selection analyses.
01 November 2018 - by Jason Karcher, Brian A. Sweatman
This paper discusses ways in which accountable care organizations have been identified by the Centers for Medicare and Medicaid Services (CMS) as weakening integrity and how CMS is proposing to address concerns.
02 August 2018 - by Zachary M. Davis, Phil Ellenberg, Brian A. Sweatman
This paper and the accompanying interactive exhibits show the coefficients from the 2019 CMS HHS-HCC commercial risk adjustment model and compare how ACA experience from 2016 EDGE data incorporated into the 2019 model will affect risk scores, which have a direct impact on an issuer’s risk adjustment transfer.
