Hugh Larson
Principal
San Diego, CA, US
Hugh Larson is a principal with the San Diego office of Milliman. He joined the firm in 2015.
Experience
Hugh has been providing healthcare management consulting services for over 30 years. During this time, he has worked with all types of participants in the healthcare marketplace - providers, payors, insurers/TPAs, and government agencies.
In his current role as a principal with the San Diego office, he leads a practice that works with organizations at the forefront of alternative healthcare payment arrangements and methodologies for healthcare treatment. He and his team provide both strategic planning advice as well as technical business analyses and data analytics. Some examples of the types of projects Hugh has recently worked on are:
- Working with a county-owned an integrated healthcare system to develop a forecast of the future demand for healthcare services by provider type and patient characteristics
- Assisting a medical software start-up to evaluate the costs and utilization of current treatment modalities for the affected condition and estimate reduced future costs from changed treatment modalities
- Creating “straw man” strategies for a new-entrant in the U.S. healthcare market to engage existing healthcare insurers in unique risk arrangements
- Evaluating and negotiating risk contracts for large physician organizations
- Providing risk assessments for a tech-based health company evaluating an acquisition of a children’s health system
- Advising organizations that are considering or participating in a variety of CMS’ alternative payment programs, including the ACO REACH, Direct Contracting, Next Gen ACO, MSSP, and Enhancing Oncology Model
Publications and Presentations
- Headwinds for Delegated Groups in Medicare Advantage. APG Inland Empire Regional Meeting, 2023.
- Gazing into the Healthcare Crystal Ball - Emerging and Anticipated Changes in Provider Reimbursement, Use of Technology and Business Practices. APG Regional Meetings in Oakland, Seattle, Phoenix, and Denver in 2021 and 2022.
- Direct Contracting and the Impact of COVID-19 on Physicians. Milliman White Paper, 2021.
- New Geographic Direct Contracting Model is a Game Changer. Milliman White Paper, 2020.
- "Pathways to Success" MSSP Proposed Regulation. Milliman White Paper, 2018.
- MSSP Track 1, 1+, 2, 3 and Next Gen: What is the Difference? The Devil is in the Details. CAPG Colloquium 2017.
- Considerations Regarding the Next Generation ACO Stop-Loss Methodology. Milliman White Paper, 2017.
- Individual Stop-Loss is Now Optional for Next Generation ACOs. Milliman White Paper, 2017.
- Medicare Shared Savings Program 2016 Track 3 Financial Results. Milliman White Paper, 2017.
- Healthcare System Delivery Reform, Payment Reform and Provider Risk. Conference of Consulting Actuaries Annual Meeting 2016.
- Impact of Next Generation ACO Model on Medicare Spending in 2016. Milliman White Paper, 2016.
Education
- B.A. in Mathematics, University of California, San Diego
Affiliations
- Hugh is an Ambassador in the Global Actuarial Initiative - a partnership between Milliman and the United Nations Development Program. In this role, he has spent time in Addas Ababa meeting with stakeholders (including insurance regulators, insurance companies, educational institutions and donors) to foster interest in establishing a working group for an actuarial profession in Ethiopia.
Publications
Read their latest work
Article
Direct Contracting and the impact of COVID-19 on physicians
08 January 2021 - by Coleen Young, Hugh Larson, Annie Man
Recent Direct Contracting adjustments have created an opportunity for organizations considering becoming Direct Contracting Entities to attract physicians who might not have been interested previously.
Article
New Geographic Direct Contracting Model is a game changer
21 December 2020 - by Coleen Young, Hugh Larson, Emma Kramer, Noah Champagne, Raheel Sohail
While the Geographic Direct Contracting Model shares some general characteristics with the other Direct Contracting Model Options, it is a fundamentally different approach in many key respects.
Article
Impact of Next Generation ACO Model on Medicare spending in 2016
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.
Article
“Pathways to Success” MSSP proposed regulation: Summary white paper
20 August 2018 - by Colleen Norris, Cory Gusland, Charlie Mills, Hugh Larson
This paper provides a summary of the Centers for Medicare and Medicaid Services’ sweeping proposed regulations that will significantly change the Medicare Shared Savings Program.
Article
Considerations regarding the Next Generation ACO stop-loss methodology
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.
Article
Medicare Shared Savings Program 2016 Track 3 financial results
22 December 2017 - by Hugh Larson, Annie Man, Tim Wilder, Coleen Young
This paper discusses first year Medicare Shared Savings Program Track 3 performance and possible drivers of success.
Article
Individual stop-loss is now optional for Next Generation ACOs
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.
Article
Next Generation ACO Program financial results for 2016
08 November 2017 - by Hugh Larson, Annie Man, Tim Wilder, Coleen Young
This paper describes the financial results of the Next Generation Accountable Care Organizations program.