Modeling, Statistics, and Actuarial Analysis

With more than 35 years of proven experience, we have earned the confidence of the health and human services policymaking community for conducting a vast array of important quantitative analyses. Our hallmarks are methodological rigor, objectivity, and willingness to disclose our data sources, methods, and assumptions. The findings and estimates of The Lewin Group reflect careful consideration of all appropriate aspects of an issue or program.

Cost savings/impact analysis

The Lewin Group has prepared thousands of estimates of the costs and savings associated with existing programs and potential new initiatives. These estimation projects encompass an array of issues including reimbursement options, coordinated care initiatives, benefits design, program eligibility design, taxation, and alternative approaches to performing administrative functions.

Health care reform

The Lewin Group has been at the forefront of many national and state health reform efforts and has provided cost estimates of different approaches to expanding coverage of currently uninsured population subgroups. In addition to estimating the impact of governmental spending — and its many associated dimensions — our modeling also assesses employer and individual behaviors under various approaches to health reform, as well as provider impacts.

Workforce planning

We have developed and applied models of the supply and demand for health professionals. These models provide insights for our clients regarding future excess demand or supply conditions, and the impact of individual factors affecting supply and demand. Our insight into future conditions can lead to ways to adapt to those conditions or change them through intervention.

The Lewin Group applies econometric methods to recent and historical data to help us estimate the effects that various factors — such as insurance coverage, managed care penetration, and demographic and economic measures — have on the demand for health services. Our analysis of hours of work, retirement patterns, and new entrants helps us estimate future supply. We incorporate our estimates into a user-friendly, computer-based platform that allows users to project the effects of baseline cases and alternative scenarios.

We have developed models for physicians and for subspecialties such as endocrinologists, rheumatologists, physiatrists, nurses, and pharmacists. Our clients have used the implications of our models to develop policies regarding graduate medical education, areas for practice expansion, and strategies for recruiting and retaining health professionals.

Capitation rate setting

The Lewin Group has designed reimbursement methodologies and set capitation rates for a range of Medicaid managed care programs that offer comprehensive benefit packages and programs focusing on specialty services or special needs populations.

Reflecting the needs of our clients and the marketplace, our reimbursement design ranges from full-risk programs to aggregate or individual risk-sharing arrangements to administrative services only (ASO) arrangements, which include contractor incentive payments for meeting or exceeding per member per month (pmpm) cost targets.

We have worked extensively with Medicaid claims data, HMO encounter data, and detailed eligibility data to calculate pmpm costs and utilization rates and develop fair and accurate reimbursement structures and payment rates.

“The Lewin Group [is] the gold standard of independent health-care analysis.”

Senators Ron Wyden (D-OR) and Bob Bennett (R-UT)
Wall Street Journal, June 26, 2007