Tammy Tomczyk

Tammy is a Partner in the Milwaukee, WI office of Oliver Wyman Actuarial Consulting, Inc. Tammy has over 25 years of actuarial experience and she specializes in actuarial and strategic consulting to health plans, managed care organizations, providers, and state and federal regulators.

Relevant Experience

Her experience includes product development and new market entry strategy for payers, pricing of commercial and Medicare Advantage products, deep claims analytics including total cost of care management, contract evaluation, pro-forma forecasting, underwriting strategy and process reviews, and modeling the impact of healthcare policy changes.

Tammy has assisted health plans develop pricing and product strategies, evaluate fee schedules and perform network sculpting strategies, and has performed comprehensive reviews of new business and renewal underwriting strategies including the development of merit underwriting models. She has also performed assessments, implementation, and outcome evaluation of various risk sharing and risk-based contracting arrangements, and has performed deep claim analytics including propensity matched cost and utilization benchmarking against managed populations as part of total cost of care management strategies.

She has extensive experience managing large and diverse projects, including projects to model the impact of insurance market reforms, studies to analyze the financial impact of legislative and regulatory proposals, modeling ways to stabilize the individual market and reduce the number of uninsured individuals, performing demand driven analytics to assess future physician staffing and clinical asset needs for specific populations, and performing statewide healthcare expenditure and total cost of care studies.

Tammy is considered an industry expert on the Affordable Care Act (ACA), specializing in the individual and small group markets. In addition to assisting health plans in the development of strategies and pricing of ACA compliant products, she has assisted many states in modeling the impact of various reform initiatives and studying their options under Section 1332 of the ACA, including actuarial analysis to support several successful Section 1332 Waiver applications. She has also assisted states with the development and implementation of effective rate review programs and the development and implementation of experience based workers’ compensation medical fee schedules.

Among her professional activities she has provided testimony before the United States Senate Committee on Health, Education, Labor and Pensions related to stabilizing premiums in the Individual market, previously served as Vice Chair of the American Academy of Actuaries Health Practice Council, and has served as an expert witness providing testimony at hearings in Maryland, Vermont, Virginia and the District of Columbia. She has also co-authored numerous reports and studies related to the Affordable Care Act.