Health Care Providers, Self-Funded Plans, HMOs, PHOs, PPOs, Managed Care, Physician Groups, Dental Plans, Employee Benefits

Wakely Consulting has extensive experience in diverse health care sectors, offering you a realistic, practical approach to actuarial and compliance solutions:

Carriers
Providers
Self-Funded Plans
Consultants
Government Agencies

We recognize the divergent and, at times, conflicting objectives of HMOs and insurance companies wanting to pay low yet reasonable reimbursements to providers; doctors and hospitals wanting fair fee levels; employers and employees wanting low premiums; and all wanting quality health care.

With the passage of the landmark Patient Protection and Affordable Care Act (PPACA, or ACA for short), health care reform has significant short- and long-term provisions that will affect patients, health care providers, health plans, regulators, employers, taxpayers and other participants in the health care industry.

As a result, Wakely Consulting can craft customized solutions that competitively integrate your organization’s particular needs within this “minefield” of different health care players and competing objectives.

Below are some of the many businesses we serve:

Carriers

Life and Health Insurance Companies

Health Maintenance Organizations (HMOs)

Reinsurers

Providers

Hospital Systems

Physician Groups (IPAs, Multi-Specialty Groups, Clinics, etc.)

Physician Hospital Organizations (PHOs)

Preferred Provider Organizations (PPOs)

Prepaid Limited Health Services Organizations (PLHSOs) —

Dental, Vision, "Clinic Only" Plans

Dental Practices

Pharmacy Benefit Managers

Self-Funded Plans

Third-Party Administrators (TPAs)

Employers (Private, Government, Municipal)

Consultants

Managing General Underwriters (MGUs)

Employee Benefits Consultants

Government Agencies

State Insurance Departments

Counties and Municipalities