Medicare 101 for Health Tech Startups
Medicare 101 for Health Tech Startups
This session provides a foundational overview of Medicare, focusing on key aspects such as federal spending, coverage, and benefits. Attendees will learn about the distinctions between Original Medicare and Medicare Advantage, including enrollment trends, plan structures, and the Medicare Advantage bidding process. Additionally, the session will explore plan revenue models, benchmarks, star ratings, and supplemental benefits. Special populations like dual-eligible beneficiaries will also be discussed, offering startups critical insights into aligning their solutions with Medicare’s evolving landscapes.
Meet our panel:
Deana Bell, FSA, MAAA is a Principal & Consulting Actuary in the Milliman Seattle Health office and she joined the firm in 2005. Deana is a health insurance consultant and her experience includes actuarial opinions, pricing, rating, reserving, medical underwriting, benchmarking, and risk adjustment projects. Deana works primarily with group health care programs, including Medicare and Medicaid plans, commercial insurance, Veterans Health Administration, provider groups, and health tech solutions and start-ups.
LinkedIn: https://www.linkedin.com/in/deanabell/
Matt Kridgen, FSA, MAAA is a Consulting Actuary in the Milliman Seattle Health office. He joined the firm in 2014 and has over 11 years of experience working as a healthcare actuary. His main area of focus is supporting health plans in the Medicare Advantage and Medicaid markets. Matt assists plans in bid development, reserving, year-end reporting, audits, revenue optimization, benefit pricing, financial projections, experience monitoring, provider contracting, capitation rate setting, and risk score analysis. He also does extensive research into the effects of medical management on member costs in commercial healthcare markets.
LinkedIn: https://www.linkedin.com/in/dara-smith-b0757244/
Dara Smith is a growth-oriented leader with more than 25 years of experience working with health plans, solving problems in the healthcare industry, especially in Medicare Advantage. She focuses on financial success, operations, and strategy to help organizations achieve their goals and optimize their performance. She is currently a Principal for Health Management Associates in Seattle, WA, a national healthcare and human services consulting firm. Her market understanding allows her to work with companies to launch profitable products and services, lead successful turnarounds, and support cross-functional collaboration. Dara is a graduate of Duquesne University in Pittsburgh, PA and West Virginia University in Morgantown, WV.
LinkedIn: https://www.linkedin.com/in/matthew-kridgen-20212857/