The shifting of financial risk from commercial insurers to providers presents a host of new challenges and opportunities for all parties involved. Milliman actuaries and consultants assist both providers (hospitals, provider systems, etc.) and insurers in navigating the complexities of these arrangements—from contracting through implementation to long-term program management. Milliman provides unique insight into the financial complexities of these contracts, quantitatively modeling the impact of program features (including shared savings parameters, beneficiary attribution, risk adjustment terms, etc.) and working with clients to both optimize the contract terms and the strategic response to a value-based contract. Our role as strategic partner has helped numerous providers and insurers not just survive but also thrive in the transition to a shared risk environment.