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Emma Kramer

FSA, CERA, MAAA
Principal and Consulting Actuary
Brookfield, WI, US

Emma Kramer is a principal and consulting actuary with the Milwaukee office of Milliman. She joined the firm in 2013.

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Experience

Emma assists clients with Medicare risk programs, including ACO REACH, Medicare Advantage, and the Medicare Shared Savings Program (MSSP).

Emma is a Chartered Enterprise Risk Analyst. She assists insurance companies with various risk assessments, including Own Risk and Solvency Assessments (ORSAs).

Prior to joining Milliman, Emma spent several years working for two large health insurance companies where she supported contract negotiations with health care providers, as well as pricing, reserving, and forecasting for commercial lines of business in several states.

Publications

Read their latest work

Article

ACO Primary Care Flex Model: Five key takeaways for ACOs considering participation

18 July 2024 - by Sam Shellabarger, Emma Kramer
We offer tips for ACOs considering participation in the ACO Primary Care Flex model offered by the Centers for Medicare and Medicaid Services.
Article

Shadow bundles: A big opportunity for MSSP and REACH ACOs

13 February 2024 - by Maggie Alston, Noah Champagne, Daniel DiNinno, Emma Kramer, Christopher Murphy
New data for the Medicare Shared Savings Program and ACO REACH models provide opportunities for managing referrals, but ACOs should know the data’s limitations.
Article

Interactions between the CIF and the +/- 3% risk score floor and ceiling in ACO REACH

10 January 2024 - by Emma Kramer, Caroline Li
With the Centers for Medicare & Medicaid Services’ ACO REACH Coding Intensity Factor, accountable care organizations face potential financial headwinds for plan years 2023 and 2024.
Article

Recent changes to ACO REACH financial benchmark methodology to account for PY 2024 fee schedule changes

07 December 2023 - by Emma Kramer, Caroline Li, Amanda Snyder
As the CMS Innovation Center revises how the ACO REACH Rate Book handles performance-year fee schedules, we provide average impact estimates at a state level and background information regarding the change.
Article

Reactions and thoughts on PY2024 ACO REACH methodology changes

07 September 2023 - by Emma Kramer, Noah Champagne, Sam Shellabarger
We summarize in detail the Center for Medicare and Medicaid Innovation’s guidance on methodology changes to the ACO REACH model.
Article

The Retrospective Trend Adjustment in Direct Contracting and ACO REACH: A brief explanation

05 December 2022 - by Emma Kramer, David Byron
It is essential that Direct Contracting Entities adjust their performance projections according to the Retrospective Trend Adjustment going into 2023.
Article

Evaluating the financial cost of the asymmetry in the MSSP risk score growth cap

10 May 2022 - by Jessica Kildow, Cory Gusland, Emma Kramer, Caroline Li
Milliman evaluated the financial impact of three alternative financial benchmark adjustment methodologies that aim to mitigate the adverse consequence to ACOs.
Article

Performance monitoring and growth support in MSSP and ACO REACH

18 April 2022 - by Kathryn Rains-McNally, Emma Kramer
ACOs should examine provider-level financial benchmarks both for performance monitoring and growth strategy.
Article

Hospital payments for COVID-19 inpatient treatment: An analysis of inpatient claims data

13 May 2021 - by Emma Kramer, Carol Bazell, Matt Mraz
Our analysis of inpatient claims data shows large variations in hospital payments for COVID-19 inpatient treatment in 2020.
Article

Medicare FFS Direct Contracting: Financial benchmark observations

04 January 2021 - by Emma Kramer, Sam Shellabarger, Erica Reijula
This white paper compares and contrasts the financial benchmark methodology between the Direct Contracting Global and Professional options and the Medicare Shared Savings Program.