NADP Knowledge Center
Sept. 21 - Beyond Network Discounts: Assessing the Value of Your Dental Provider Networks
Recorded On: 09/21/2022
Beyond Network Discounts: Assessing the Value of Your Dental Provider Networks
Wednesday, September 21
10:15 AM – 11:15 AM CT
Dental provider network strength is a critical aspect of the competitiveness of dental insurance products. The panel will discuss the various elements that are important to consider when assessing the competitiveness and financial value of a dental provider network, and how to use data to gain insights into how to improve network positioning.
Tory Carver, FSA, MAAA
Actuary at Milliman
Tory Carver is an actuary with Milliman’s Hartford, Connecticut office. She joined the firm in 2017. As a member of the Hartford health practice, Tory assists with various projects for both public and private sector clients, including insurance companies, employers, pharmaceutical manufacturers, Medicare plan sponsors, dental insurers and special interest groups. Tory has experience with dental plan pricing for both commercial and Medicaid populations. She assists in premium rate development, provider contract analysis and has done core actuarial dental pricing and underwriting work for many dental carriers. She helps with Milliman’s Dental Actuarial Analytics PPO Network Study. This product uses a vast contributor database of dental claims to provide competitive insights on dental network discounts and utilization to study participants. Tory also has experience with the individual Medicare Part D market. She assists Medicare Part D plan sponsors with plan design, formulary design, and pricing of prescription drug plans. Tory also has experience modeling changes to the parameters of the Part D program. Tory currently serves as a contact for the Hartford Health practice’s recruiting efforts. She is a fellow of the Society of Actuaries and a member of the American Academy of Actuaries. Tory earned her B.S. in Mathematics and Business Administration from Northeastern University and graduated Summa Cum Laude.
Joanne Fontana, FSA, MAAA
Principal and Consulting Actuary at Milliman
Joanne Fontana is a principal and consulting actuary in the Health Practice of Milliman’s Hartford office. She has been with the firm since 2006. During that time, she has consulted for insurance companies, including several major dental carriers, employers, government entities, and other organizations. Joanne’s focus has been mainly on managed care and dental, with experience in premium rate development, provider contract analysis, valuation of post-retirement health benefits and health care reform. Over the past several years, she has worked closely with the National Association of Dental Plans, the California Association of Dental Plans, the American Dental Association, and other dental clients to assess the impact of health care reform on the dental industry. She manages Milliman’s Dental Actuarial Analytics PPO Network Study. This product uses a vast contributor database of dental claims to provide competitive insights on dental network discounts and utilization to study participants. She has worked with carriers and employer groups on dental insurance procurement and Medicaid dental procurements with state entities and bidders. She has done core actuarial dental pricing and underwriting work for many dental carriers. Joanne is considered an industry expert in dental products and pricing; she has presented on dental-related issues at multiple industry forums and authored many topical articles. Before joining Milliman, Joanne spent more than 10 years as an actuary with Cigna, where she held various healthcare financial leadership roles, including Chief Actuary of CIGNA’s dental insurance business.
Nolan Kurtz, Ph.D., FSA, MAAA
Actuary at Milliman
Nolan Kurtz is an actuary in the Hartford office of Milliman. He joined the firm in 2016. Nolan has a research background in programming languages, statistical software and predictive analytics. Before joining Milliman full-time, he held an internship at Milliman’s Hartford Health Practice. Nolan has a strong background in data analytics with pharmacy, medical, and dental claims in commercial and Medicare markets. He has worked with medical, pharmacy, and dental claims in multiple countries with varying levels of data quality and different development environments. Nolan has worked on projects addressing marketplace-wide surveys of pharmacy benefits, the impacts of point of service rebate sharing, pharmacy claim re-adjudication, health risk adjusters in China, PBM profitability visualization dashboards, Medicare Advantage and Part D pricing, dental network analysis and pharmacy investigations. He also manages the back end of the GASBHelp.com website, which helps small government employers comply with Other than pension Post-Employment Benefits.
Tom Murawski, FSA, MAAA
Actuary at Milliman
Tom Murawski is an actuary with the Hartford, Connecticut, office of Milliman. He joined the firm in 2009. Tom provides consulting services to various clients in the U.S. healthcare system, including insurance companies, stop-loss carriers, employers, provider groups, government entities and advocacy groups. Tom’s focus has been on advising clients in understanding the impact and strategic implications of the ACA. His experience includes pricing health benefits, estimating reserves and projecting financial results. Tom has led projects to assist clients in these activities for many different health products, including individual plans, small and large group plans and stop-loss products. Tom also has significant experience with dental plan pricing for both commercial and Medicaid populations. He has been involved in studies and analyses of the impact of the ACA on dental insurance, experience analysis studies for large employers and insurers, and review of provider fee schedules. Tom frequently presents at industry and regional actuarial meetings on dental and other health benefits topics. Tom has also authored several research reports on the potential impact and implications of proposed healthcare laws and regulations. As a result of his research, Tom has met with and advised members of Congress, Congressional Budget Office leadership, and Senior White House Policy Officials on healthcare reform proposals.
Ryan Swindells, ASA, MAAA
Associate Actuary at Milliman
Ryan Swindells is an associate actuary with Milliman’s Hartford, Connecticut office. He joined the firm in 2019. Ryan assists with various projects for a diverse group of clients. He provides services for insurers, employers, pharmacy benefit managers and government entities on medical, pharmacy and dental benefits. Ryan has experience in the Medicare Advantage market. He assists with benefit design, formulary analysis, and pricing of Part D prescription drug plans for individual plan sponsors. He helps insurers with Employer Group Waiver Plan pricing in the commercial market. Recently, Ryan has been working on competitive analysis of commercial dental networks, auditing employer pharmacy benefit programs, and performing profitability tests under various pharmacy benefit designs and regulatory reforms.