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Jessica Naber

FSA, MAAA
Principal and Consulting Actuary
Indianapolis, IN, US

Jessica Naber is a principal and consulting actuary in the Health Practice of the Indianapolis office of Milliman. She is a lead in the pharmaceutical consulting group. She joined the firm in 2011.

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Experience

Jessica has been consulting with pharmaceutical companies since 2015, on topics related to market access, claims data analytics, contract modeling, and strategy. Her two primary focuses are: (1) consulting related to gene and cell therapies and the rare diseases they treat, and (2) leading technical projects that involve claims databases, data analytics, research, and model building.

Jessica is also a co-creator of Milliman DNA Gene and Cell Therapy Forecasting, a product that provides synthesized clinical and scientific research for approved and pipeline gene and cell therapies and estimates the costs and cases associated with these therapies. The product’s intended users are primary insurers, secondary insurers, PBMs, and pharmaceutical manufacturers.

Jessica has been the lead on many types of technical and non-technical projects, including:

  • Assessing the payer landscape and alternate payment models for gene and cell therapies
  • Participating in market research with insurers related to gene and cell therapy market access
  • Analyzing clinical treatment regimens and pathways before and after diagnosis using claims databases
  • Evaluating patient cost sharing and utilization behavior using claims databases
  • Supporting contract modeling and Pre-Information Exchange (PIE) strategy
  • Performing Impact of the Inflation Reduction Act (IRA) on patient cost share and manufacturer liability
  • Using dynamic modeling tools, including Excel and R Shiny

Prior to consulting with pharmaceutical manufacturers, Jessica was involved with supporting Accountable Care Organizations (ACOs) and provider payment reform, including:

  • Performing shared savings agreement financial assessments
  • Evaluating physician efficiency using episodes of care
  • Evaluating hospital, skilled nursing facility, and home health provider performance

Jessica has led and participated in a variety of research efforts. She has authored white papers and reports, some of which were published by the Society of Actuaries or their affiliated magazine. She has also presented at multiple SOA conferences and has been a guest on the SOA’s Research Insights podcast.

Publications

Read their latest work

Article

Cell and gene therapies: Informing the uncertainties using research and retrospective claims analysis

01 November 2024 - by Jessica Naber
Accurately estimating the cost exposure of cell and gene therapies requires the integration of clinical research, market monitoring, and claims analysis.
Article

CMS Cell and Gene Therapy Access Model

25 April 2024 - by Palak Desai, Jessica Naber, Prachi Bhatt, Tyler Engel
CMS’s Cell and Gene Therapy Access Model offers Medicaid programs increased access to the treatment while addressing complexities and financial uncertainties.
Article

Alzheimer's disease: An analysis of the diagnosed population and out-of-pocket cost exposure

28 February 2024 - by Jessica Naber, Scott Lain
More than 98% of Medicare beneficiaries who may be considered for amyloid-targeting therapy have coverage that limits or caps out-of-pocket exposure.
Article

Employers and targeted obesity care: Exploring the concept of an obesity center of excellence

06 February 2024 - by Jessica Naber, Austin Barrington, Bryce Platt
A targeted obesity care model combined with a risk-sharing financial component may align provider and employer incentives for treatment of obesity.
Article

Alzheimer’s disease severity progression: Prevalent population estimates over time

02 June 2023 - by Jessica Naber
By month 12, about 9% to 16% of Medicare beneficiaries diagnosed with Alzheimer’s disease with mild dementia or mild cognitive impairment will have progressed to moderate or severe symptoms.
Article

Payer Mix Analysis: Autoimmune Encephalitis (AIE) and Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease (MOG-AD)

24 January 2023 - by Jessica Naber, Kristin Niakan, Kali Schweitzer, Jake K. Klaisner
Medicare FFS and Advantage show the highest rates of AIE prevalence of at least 8 per 100,000, more than double than that in the commercial channel.
Article

Prevalence of rare disease in a commercial population using ICD-10 diagnosis codes

12 August 2022 - by Melanie K. Kuester, Jessica Naber, Conner Smith
Regenerative and targeted therapies increase the need to accurately identify rare diseases, and increased specificity in diagnosis codes of the ICD-10 could help
Article

Medicare beneficiary out-of-pocket cost exposure for Part B drugs and services

25 May 2022 - by Jessica Naber
97% of Medicare beneficiaries 65 and older have some form of coverage that limits or caps the amount of out-of-pocket exposure for Part B drugs and services.
Article

Hospital care for the uninsured in the United States: An analysis of national data sources

24 February 2021 - by Luke B.G. Roth, Jessica Naber, Luke Metz, Nina Nikolova
An analysis of hospital care for the uninsured in the United States shows charity care costs are rising.
Article

Managing risks related to gene and cell therapies for self-insured employers with stop-loss coverage

07 January 2020 - by Robert Bachler, Elizabeth Anne Jackson, Jessica Naber, Brenda Runyan
This paper introduces why self-insured employers with stop-loss coverage may still be exposed to some of the costs of gene and cell therapies, explores considerations and a potential imbalance of financial risk for the self-insured employer and stop-loss carrier when implementing a multiyear performance-based payment arrangement, and discusses potential ways to efficiently contract between the self-insured employer, stop-loss carrier, and manufacturer to better share the financial risk.