Brian A. Sweatman
MBA, FSA, MAAA
Principal, Consulting Actuary
Atlanta, GA, US
Brian Sweatman is a principal and consulting actuary with the Atlanta office of Milliman. He joined the firm in 2013.
Experience
Brian primarily consults with providers, commercial insurers, and large employers. His client activities include:
- Value-based payment model strategy, design, and pricing (including bundled payments, shared savings/risk arrangements, capitation, and joint ventures)
- Population health analytics
- Utilization and cost benchmarking
- Fee schedule analysis
- Custom network design and pricing
- Healthcare cost analysis
- Preparation of commercial regulatory rate filings for both ACA and non-ACA products, including individual and group
- Pricing and rate development
- Alternative payment model support
- Analysis of actuarial liabilities
Prior to joining Milliman, Brian was an analyst with Coventry Health Care and previously worked with AonHewitt.
Publications and Presentations
- How will EDGE affect your 2019 ACA Risk Adjustment Transfer? (Published on milliman.com, August 2018).
- "Pathways to Success" MSSP proposed rule: Integrity (published on milliman.com, November 2018).
- Value-Based Payment Models - Actuarial Considerations (Southeastern Actuaries Conference Fall Meeting, Nashville, TN, November 2018).
- Considering trend guarantees in your next TPA selection analysis (published on milliman.com, May 2019).
- Direct contracting strategies for employers (published on milliman.com, May 2020).
- Ten questions providers should be asking about their value-based contracts and the COVID-19 pandemic (published on milliman.com, May 2020).
- Direct Contracting and Other Models: How CMS, Providers, and Employers Continue to Challenge the Status Quo (Society of Actuaries Virtual Health Meeting, June 2020).
- Payer-Provider Collaboration: The Road Behind, The Road Ahead (Conference of Consulting Actuaries Webinar, June 2021).
Professional Designations
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
Education
- BBA, Actuarial Science, Georgia State University
- Executive MBA, Quantic School of Business & Technology
Publications
Read their latest work
Article
Direct-to-employer contracting for bundled payments: Key considerations for providers
19 February 2025 - by Christopher Murphy, Brian A. Sweatman, Paul Sakhrani, Scott Cohen, Alyssa Martin
We review the key considerations for providers when handling direct-to-employer contracts for bundled payments.
Article
What are bundled payments and how can they be used by healthcare organizations?
27 March 2023 - by Carol Bazell, Maggie Alston, Pamela M. Pelizzari, Brian A. Sweatman
With the CMS, Medicare Advantage organizations, Medicaid organizations, and health plans experimenting with bundled payments, we offer a primer and perspectives.
Article
Capitation in commercial lines of business
03 November 2021 - by Brian A. Sweatman, Louisa Bonds
We cover the basics of capitation and explore some of the challenges that are unique to commercial health insurance lines of business.
Article
Ten questions providers should be asking about their value-based contracts and the COVID-19 pandemic
19 May 2020 - by Cory Gusland, Anders Larson, Brian A. Sweatman
For any given provider organization, the impact of COVID-19 on its value-based contracts will depend largely on certain actuarial, legal, and strategic aspects of each agreement.
Article
Direct contracting strategies for employers
08 May 2020 - by Brian A. Sweatman, Shyam Kolli
This paper summarizes a few direct contracting strategies observed in the marketplace and identifies key areas for considerations as employers evaluate these options.
Article
Considering trend guarantees in your next TPA selection analysis
01 May 2019 - by Scott Cohen, Paul Sakhrani, Brian A. Sweatman
There is increased interest from both employers and third-party administrators (TPAs) in incorporating medical trend guarantees into TPA selection analyses.
Article
“Pathways to Success” MSSP proposed rule: Integrity
01 November 2018 - by Jason Karcher, Brian A. Sweatman
This paper discusses ways in which accountable care organizations have been identified by the Centers for Medicare and Medicaid Services (CMS) as weakening integrity and how CMS is proposing to address concerns.
Article
How will EDGE affect your 2019 ACA Risk Adjustment Transfer?
02 August 2018 - by Zachary M. Davis, Phil Ellenberg, Brian A. Sweatman
This paper and the accompanying interactive exhibits show the coefficients from the 2019 CMS HHS-HCC commercial risk adjustment model and compare how ACA experience from 2016 EDGE data incorporated into the 2019 model will affect risk scores, which have a direct impact on an issuer’s risk adjustment transfer.