Kathryn Rains-McNally
FSA, MAAA
Principal and Consulting Actuary
Seattle, WA, US
Kathryn Rains-McNally is a principal and consulting actuary with the Seattle office of Milliman.
Experience
Kathryn is an experienced actuary with 20 years of experience and a diverse background, having worked at both a health plan and a provider system, in addition to many years as a consulting actuary. Kathryn is well-versed in commercial rating and underwriting, Medicare Advantage bidding, and essentially all forms of provider/payer contracting.
Kathryn’s areas of expertise include:
- Medicare Advantage bid development and ongoing Medicare Advantage support, including product feasibility and risk adjustment analyses
- Commercial rating and underwriting, including ACA rate filings and risk adjustment
- Payer and provider contracting – fee-for-service, direct-to-employer, capitation, commercial risk, Medicare Shared Savings Program and CMS Direct Contracting, Centers of Excellence, bundled payments, and other alternative payment arrangements
- Expertise in contract negotiation strategy, rate modeling, and helping providers understand risk and opportunity inherent in alternative payment arrangements
Publications and Presentations
- Performance monitoring and growth support in MSSP and ACO REACH (Milliman White Paper, April 2022)
- Full disclosure: Price transparency for health plans (Milliman White Paper, September 2021)
- Understanding Medicare Disproportionate Share changes for FY 2014 (Milliman Research Report, March 2014)
- Evaluating Bundled Payment Contracting (Milliman Healthcare Reform Briefing Paper, December 2011)
Professional Designations
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
Education
- BA, Mathematics and Chemistry, Macalester College
Publications
Read their latest work
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
Full disclosure: Price transparency for health plans
14 September 2021 - by Kathryn Rains-McNally, John M. Pickering
Recent changes in health plan and hospital transparency rules have potential to expand transparency to commercial market.
Article
Understanding Medicare Disproportionate Share changes for FY 2014
10 March 2014 - by Charlie Mills, Kathryn Rains-McNally
Changes to the disproportionate share hospital (DSH) payment methodology are expected to lower disproportionate share hospital payments, but the impact by area and provider varies significantly.