James Lucas is a Principal with the Actuarial Practice of Oliver Wyman, specializing in provider value-based care and Medicare Advantage pricing. His experience in
value-based care includes:
- Provider incentive modeling for both primary care and specialty physicians, focusing on simplifying the key value drivers for physicians to focus on while in an ACO with varying risk contracts across Medicare, Commercial, and Medicaid
- Primary care physician revenue model development with a focus on transitioning from RVUs to partial risk value-based incentives
- CMMI / MSSP strategy and financial modeling across various CMS model designs
- Implementation of analytics platform to standardize data structure and quality across multiple payer / provider arrangements
In addition to value-based care and Medicare Advantage pricing, James’ experience also encompasses Commercial pricing (ACA, small group, large group), risk management, care management design and strategy, value-based contract assessment, and provider strategy operations. Prior to joining Oliver Wyman, James started and oversaw the actuarial and medical economics department at Banner Health, a large regional healthcare provider system.