Rebecca Smith
Rebecca Smith is a senior healthcare management consultant with the New York office of Milliman. She joined the firm in 2020.
Experience
Rebecca has a broad background in commercial payer operations, clinical policy, and coverage decision making, as well as health outcomes analysis. She specializes in using real-world administrative claims data to conduct health economics research as well as health technology and value assessments. She also focuses on market access strategy development, including value-based contracting and broader health policy topics.
Rebecca has extensive knowledge of care management, utilization management, and preauthorization operations within the payer space. She has tested the viability of novel alternative payment arrangements for biosimilar drugs, developed claims-based machine learning algorithms for cancer identification, and evaluated the feasibility of health product offerings and value-based payment arrangements in the commercial and Medicare spaces. Rebecca has significant experience in the oncology, diabetes, kidney, and respiratory care spaces.
Prior to joining Milliman, Rebecca held a senior management role in the Medical Affairs division at Aetna and CVS Health, where she was responsible for identifying opportunities to drive medical cost savings and quality improvement for the enterprise. Rebecca was also involved in assessing clinical policy and coverage decisions and developing new clinical products and services. She covered several medical cost categories, including endocrinology, gastroenterology, preventive health, and complex and critical care. In this role, she also created and implemented clinical programs in the retail clinic setting and served as Aetna and CVS Health's liaison to the FDA's Payor Communication Taskforce.
- Smith, R., Miller-Wilson, L.A., Ho, N., Cuyun, Carter G., Fayyaz, I., Pope, A., Pelizzari, P., Pyenson, B. Validating a Machine-Learning Approach to Cancer Stage Identification Using Medicare Claims and SEER Data. Value in Health, Volume 26, Issue 6, S2 (June 2023).
- Smith, R., Miller-Wilson, L.A., Ho, N., Cuyun, Carter G., Fayyaz, I., Pope, A., Pelizzari, P., Pyenson, B. Validating the use of machine-learning cancer staging algorithms for Medicare cost analyses. J Clin Oncol 41, 2023 (suppl 16; abstr e13548).
- Smith, R.A., Dieguez, G., Cockrum, P., Ramirez, R.A. Comparing costs for Medicare FFS patients treated with etoposide or irinotecan for extensive stage small cell lung cancer. World Conference on Lung Cancer: August 6-9, 2022; Vienna, Austria.
- Smith, R.A., Dieguez, G., Cockrum, P., & Ramirez, R.A. Comparing costs for Medicare FFS patients treated with etoposide or irinotecan for extensive stage small cell lung cancer. World Conference on Lung Cancer: August 6-9, 2022; Vienna, Austria.
- Cockrum, P., Dieguez, G., Smith, R.A., & Ramirez, R.A. Real-world resource use and costs by stage and platinum sensitivity among Medicare patients with small cell lung cancer. World Conference on Lung Cancer: August 6-9, 2022; Vienna, Austria.
- Dieguez, G., Cockrum, P., Smith, R.A., & Ramirez, R.A. Real-world impact of platinum sensitivity and disease stage on survival among Medicare patients with small cell lung cancer. World Conference on Lung Cancer: August 6-9, 2022; Vienna, Austria.
- Dieguez, G., Cockrum, P., Smith, R.A., & Ramirez, R.A. Characterizing Platinum Sensitivity among Medicare FFS Patients with Limited vs Extensive Stage Small Cell Lung Cancer Receiving NCCN® Category 1 Preferred Regimens. American Society of Clinical Oncology Annual Meeting: June 3-7, 2022; Chicago, IL.
- Yang, J., Carioto, et al. Greater uptake, an alternative reimbursement methodology needed to realize cost-saving potential of oncology biosimilars in the United States. J Manag Care Spec Pharm. 2021;27(12):1642-1651.
- Dieguez, G. & Smith, R. The impact of earlier CKD detection and delayed disease progression. Milliman, Inc. Jul 2021.
- Pyenson, B., Pelizzari, P., Smith, R., & Latimer, H. Assessing the value of therapies in Alzheimer’s disease: Considerations to create a practical approach to value. Milliman, Inc. May 2021.
- Mirchandani, H., Tomicki, S., Smith, R., Johnson, R., Maraldo, S., & Yang, A. Racial disparities in preventive services for Medicare FFS beneficiaries with type 2 diabetes. Milliman, Inc. Feb 2021.
- BA, Human Evolutionary Biology, Harvard University
- MBA, Columbia Business School