Melek Consulting Services

We provide Actuarial & Behavioral Healthcare Consulting services for your health care organization to help you deliver excellent health insurance plan benefits to your customers, including physical and behavioral healthcare, in an integrated healthcare approach through whole-person care.

Consulting Services

Mental Health Parity Compliance

We test health plan compliance with the quantitative and nonquantitative requirements of MHPAEA. Quantitative testing checks that financial requirements and quantitative treatment limits for mental health and substance use disorder benefits are no more restrictive than the predominant levels for medical/surgical benefits. We also test compliance with nonquantitative treatment limits, which are becoming increasingly more investigated and evaluated by regulators.

Policy Analysis and Special Topics Research

We evaluate and forecast the potential impact of current or future mental health and substance use disorder policies. This can include quantifying the prevalence, variation, or impact of emerging behavioral health changes in benefit design, provider makeup, care management, or other elements of change.

Integrated Medical-Behavioral Healthcare

We evaluate the economic impact of integrated medical and behavioral care approaches, including developing financial support and staffing models, calculating return on investment, and researching the impact of treating medical and behavioral comorbidities on total cost of care.

Program Design and Evaluation

We analyze outcomes of population health, disease management, substance use treatment, and other types of behavioral programs with the goal of identifying areas of improvement in program design, cost of care and delivery.

Financial Projections

We perform analyses such as projecting healthcare costs and utilization by type of service, evaluating budgets and rate adequacy, and estimating cost savings from new programs or other interventions.

Development of Alternative Payment Models

We design elements of risk management for behavioral healthcare providers in their contracting efforts, with the potential of including capitation rates, risk-sharing arrangements, incentive payments, and performance guarantees.

Fee Schedule Evaluation

We analyze provider fee schedules for behavioral providers either over time, or at a point in time, and compare them to area-specific and national benchmarks.

Cost and Utilization Benchmarking

We evaluate behavioral healthcare costs and utilization metrics by service category against area-specific or other carrier data.

Rate Setting and Negotiation Support

We analyze provider fee schedules for behavioral providers either over time, or at a point in time, and compare them to area-specific and national benchmarks.