Wakely

What Wakely does

Wakely Consulting Group is a US-based healthcare actuarial and consulting firm serving health plans, providers, government entities, employers, ACOs, care management vendors, and private equity clients. The firm's actuarial practice traces to 1969, and Wakely was established as an independent company in 1999 before becoming a subsidiary of Health Management Associates (HMA) in 2021. Wakely operates across eight US offices (Clearwater HQ, Atlanta, Denver, Madison, Minneapolis, Pleasantville, NYC, Phoenix, Tampa) with more than 200 actuarial experts and consultants, and is led by CEO Kelsey Stevens and COO Mary Hegemann.

The firm's core technology stack comprises more than 15 proprietary analytical tools and databases, including WIDEN (dual-eligible strategy), NEST (MA network optimization), SMART (market analysis), WMACAT (Medicare Advantage competitive analysis), WACA (ACA database), WNRAR (risk adjustment data covering 35 states and 19 million lives), RADIAL (data integrity), RAPID (encounter data discrepancies), and the Risk Assessment (WRA) model. In November 2025, Wakely launched ACO Optimization Retrosight and Futuresight products in partnership with Lightbeam Health Solutions, extending its footprint into value-based care provider analytics. The firm is SOC 2 Type 2 certified and supports direct data handling for client engagements.

Wakely generates revenue through fee-for-service professional consulting engagements with healthcare organizations, priced on a quote basis according to project scope and complexity. The go-to-market is sales-led, driven by direct engagement, thought leadership content (Week in Washington blog, Wakely Wire newsletter, webinars), and consultation requests. Pricing is not publicly disclosed, and contracts are typically multi-year. The firm does not report revenue publicly.

Name

Wakely

Legal name

Wakely Consulting Group

Website

https://wakely.com

Company type

Private

Founded year

1999

Operating status

Operating

Headcount range

51–100 employees

Short description

Wakely Consulting Group is a US healthcare actuarial and consulting firm serving Medicare Advantage, Medicaid, ACA, employer, and government clients with 200+ experts across 8 offices, leveraging 15+ proprietary analytics tools and databases.

Ownership category

akta.pro rank

Product category

Healthcare Actuarial Consulting Services

NAICS

Management Consulting Services (54161), Other Scientific and Technical Consulting Services (54169)

SIC

Services-Management Consulting Services (8742), Services-Computer Programming, Data Processing, Etc. (7370)

akta.pro primary industry

Value-Based Contracting Analytics (ACO/MSSP/MA, shared savings/risk) (HLACAHAA)

akta.pro secondary industries

Care Management & Coordination Platforms (case/disease management workflows) (HLACAHAD), Medicare Member Engagement & Care Management (Utilization, Case/Disease Mgmt) (FSAIAGAL)

Keywords

• Healthcare actuarial consulting
• Risk adjustment analytics
• Medicare advantage consulting
• Medicaid managed care advisory
• Value-based payment consulting

Headquarters

HQ city

Clearwater

HQ country

United States

HQ region

North America

Offices8 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales, Infrastructure

Revenue model

1. Actuarial Consulting Services: Fee-for-service consulting engagements providing actuarial expertise to healthcare organizations including health plans, providers, and government entities. Services include strategic advice, analytics, regulatory compliance support, and custom analysis.

Pricing tiers

Go-to-market motion1 record

Distribution channels1 record

Marketing channels6 records

Core offering

Wakely provides professional healthcare actuarial consulting and analytics for Medicare Advantage, Medicaid Managed Care, ACA Marketplace, employer groups, government programs, ACOs, and investment services clients. Engagements span bid preparation, RADV audit support, risk adjustment optimization, rate filing development, encounter data submissions, value-based payment modeling, quality/Star Ratings strategy, and M&A/investment advisory. The firm supplements its consulting with 20+ proprietary analytical tools and databases such as NEST, SMART, WIDEN, WMACAT, WACA, and WNRAR.

Product overview

Wakely offers a comprehensive suite of healthcare actuarial consulting services and proprietary analytics products. The portfolio includes specialized tools for Medicare Advantage (WMACAT, WIDEN, W-NEST, SMART, WAHOO, WMRAT, WPVM, WRA, WRI), ACA marketplace (WACA, WACACAT, WRINR), and risk adjustment (RADIAL, RAPID, RSO, WNRAR, RAPID-M). The core Contract Pro tool provides contract evaluation insights across all segments. Wakely also offers data sources including Medicare, Medicaid, and commercial claims data, along with consulting services spanning encounter data submissions, government/nonprofit support, quality solutions, care management, and value-based payment consulting. The company operates as an HMA company with 200+ actuarial experts across 8 offices in the US.

Differentiator

Problem solved

Functional benefit

Products and services

• Healthcare Actuarial Consulting Services Project-based professional actuarial consulting engagements for healthcare organizations across Medicare Advantage, Medicaid Managed Care, ACA Marketplace, risk adjustment, value-based payment, quality solutions, encounter data submission, employer benefits, government and nonprofit programs, ACOs, care management, and investment services.
• Contract Pro Provides clear, data-backed insights to evaluate contracts, streamline negotiations, and guide strategic decisions for healthcare organizations.
• Risk Adjustment Data Integrity Analysis & Lineage (RADIAL) Compares multiple data sources to provide transparency in risk score differences across risk adjustment programs.
• Risk Adjustment Payments: Investigation of Discrepancies Tool (RAPID) Helps plans maximize risk scores by identifying RAPS and EDS inconsistencies and getting the most out of EDGE data.
• RAPID-M (Risk Adjusted Payments & Identifying Discrepancies for Medicare Advantage Plans) Helps Medicare Advantage plans optimize risk scores by identifying RAPS and EDS inconsistencies.
• Risk Score Opportunities (RSO) Identifies and prioritizes members who are most likely to have a condition that has not been coded, supporting risk adjustment optimization.
• Wakely ACA Database (WACA) Contains the most robust and detailed ACA data available in the industry, supporting market analysis and strategic planning.
• Wakely Affordable Care Act Competitive Analysis Tool (WACACAT) Allows users to interactively explore ACA market metrics, enabling competitive analysis of the commercial insurance marketplace.
• Wakely Integrated Dual Enrollment Navigator (WIDEN) Provides insights to identify alignment opportunities and guide dual-eligible strategy for dual-eligible beneficiary populations.
• Wakely Medicare Advantage Competitive Analysis Tool (WMACAT) Allows health plans to compare Medicare Advantage benefits and market information at national, state, and county levels to evaluate plan design and performance.
• Wakely Medicare Repricing Analysis Tool (WMRAT) Aids the comparison of payment rates across multiple lines of business, categories of service, geographic locations, and providers.
• Wakely National Risk Adjustment Reporting (WNRAR) Provides risk adjustment metrics from 35 states and 19 million lives, enabling comprehensive risk adjustment analysis.
• Wakely Network Evaluation & Strategy Tool (NEST) Helps health plans and provider networks analyze, compare, and optimize Medicare Advantage networks for compliance, quality, and financial performance.
• Wakely Plan Valuation Model (WPVM) Supports pricing, mental health parity compliance, cost and utilization analysis for employer groups and healthcare organizations.
• Wakely Risk Assessment (WRA) Provides a transparent, open-code, high-performance risk assessment model for healthcare actuarial analysis.
• Wakely Risk Insight (WRI) Includes Medicare National Report (MNR) and WRI-MA components that pinpoint drivers of profitability and compare them to national benchmark data.
• Wakely Risk Insight National Reporting Project (WRINR) Identifies key profitability drivers for individual and small group ACA markets.
• Wakely Strategic Market Analysis and Ranking Tool (SMART) Provides Medicare Advantage product teams with data-driven insights to analyze markets, benchmark competitors, and design benefits that drive growth and profitability.
• Wakely Analytics Health Operations Optimization (WAHOO) Helps payers and providers optimize financial performance with a complete package of services and tools for health operations.
• Wakely Health Outcomes Benchmark and Analysis Tool (WHOBAT) Customizable model combining benchmarking, expense calculations, and medical savings analysis to quantify potential impact of supplemental benefits or managed care programs.
• Stars Calculation Tool Houses and retrieves extensive historical CMS Star Ratings and enrollment data and allows scenario-testing of measure-level values, cut-points, or Star Ratings.
• Encounter Data Submission Tool Online management tool allowing health plans to understand and prioritize errors and see the financial impact of outstanding errors.

Quantifiable outcome

• Medicare encounter claim rejection rate <1.0% (vs national average 3.0%-6.0%)
• +2 more outcomes

Segments8 records

Ideal customer profiles7 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability3 records

Feature17 records

Partnerships

One partnership is on record.

• Lightbeam Health SolutionscoreStrategic or Co-development Partner · 19 November 2025Strategic partnership to launch predictive ACO Optimization tools (ACO Optimization Retrosight and ACO Optimization Futuresight) for Accountable Care Organizations. The tools help ACOs identify underperformance, model future scenarios, and improve cost and clinical outcomes through enhanced network performance and predictive analytics.

Scale indicators8 records

Recent moves8 records

Expansion highlights6 records

Direct peers

• Milliman: Milliman is the largest pure-play healthcare actuarial consulting firm globally, providing the same core services—MA bid prep, risk adjustment, value-based care analytics, and proprietary tools—to health plans, insurers, and government clients. It is the most direct head-to-head peer in healthcare actuarial advisory.
• Avalere Health: Avalere is a specialized healthcare consulting firm focused on Medicare, Medicaid, ACA, and value-based care strategy and analytics for payers, providers, and life sciences companies—overlapping substantially with Wakely's policy, regulatory, and value-based payment consulting.
• The Chartis Group: Chartis is a healthcare-exclusive strategy and management consulting firm serving payers, providers, and ACOs with strategic, financial, and clinical advisory—directly comparable in serving health plans and value-based care clients with deep healthcare domain specialization.
• Kaufman Hall: Kaufman Hall provides financial consulting, performance improvement, and strategic advisory to hospitals, health systems, and payers—overlapping with Wakely's value-based payment, provider reimbursement, and M&A advisory segments in healthcare.
• Oliver Wyman (Healthcare & Life Sciences): Oliver Wyman's healthcare practice offers actuarial, strategic, and operational consulting to health plans, providers, and investors—directly competing with Wakely in MA/Medicaid consulting, M&A diligence (Investment Services), and value-based payment advisory.
• Huron Consulting (Healthcare): Huron operates a dedicated healthcare consulting practice advising providers, payers, and ACOs on performance improvement, value-based care, and managed services—an adjacent specialized healthcare consulting peer serving overlapping buyer segments.

Broad incumbents

• Mercer (Marsh McLennan): Mercer is a global consulting firm with a large Health & Benefits practice offering actuarial consulting, employer benefits strategy, and risk/insurance advisory—competing in Wakely's employer groups & broker consulting segment but as part of a much broader services portfolio.
• Deloitte (Health Care practice): Deloitte's Health Care practice serves payers, providers, and government health agencies with strategy, actuarial, and operations consulting—broadly overlapping with Wakely's value-based care and MA consulting but as part of a global multidisciplinary practice.
• EY-Parthenon (Health Sciences & Wellness): EY's healthcare advisory practice offers strategy, M&A, and risk consulting to health plans, providers, and life sciences companies—competing with Wakely especially in MA M&A diligence and value-based payment strategy engagements.
• Optum Advisory Services: Optum Advisory offers healthcare analytics, actuarial, and operations consulting inside the UnitedHealth Group ecosystem, including deep MA risk adjustment and value-based care expertise—competing with Wakely on payer analytics but with vastly larger data and capital resources.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights7 records

Customer concentration

• Xx.com/WakelyCG
• LinkedInlinkedin.com/company/wakely-consulting-group

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles18 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Wakely