Sara Teppema is an independent actuarial consultant specializing in value-based care and health equity. She works with stakeholders to tell their value story through modeling, data, and analytics. As Chief Actuary at Wildflower Health, she leads the actuarial and analytics team, and led a strategic transformation positioning Wildflower as the first maternal health company to take on value-based financial risk.
She is currently on the board of the Health Care Cost Institute and is vice-chair of the American Academy of Actuaries’ Health Equity Committee. She has also served on the board of the Society of Actuaries. Her 35-year career has spanned a broad range of health care stakeholders and lines of business, equipping her with a comprehensive understanding of the complexity of clinical, social, and financial health care risks.
How did you get started in healthcare? Have you always been passionate about this area, or did it happen by chance?
During campus interviews for an entry-level actuarial position, one of my interviewers talked me into specializing in health care, and I began as a health benefits consultant out of school. That same interviewer, a woman I really admire, later became a great mentor.
Since that time, I have always been passionate about health care, and over time, I developed an interest in public health and health equity. I strongly believe that health care should be a right and not a privilege, and that our system should provide everyone with the same opportunity for good health. The more I feel that I am moving the needle toward that goal, the more I enjoy my work.
You’ve had an expansive career across startups and consulting firms. What drew you to your current work at Wildflower Health, and what keeps you motivated?
Most of my career has been in consulting, and in recent years, I’ve worked with many health management solutions and startups to move them toward value-based payment models.
I started with Wildflower Health (a women’s and maternal health solution) as a consultant, designing our VBC risk and financial strategy, including a custom episode of care for maternity. I was asked to join full-time and could not turn down the opportunity to lead our amazing analytics/actuarial team, and to continue building a value-based care solution that works closely with pregnant moms.
Now that our solution is built out, I am fractional with Wildflower and also working as an independent consultant with a few other healthcare startups. I love helping newer companies strategically tell their value story, especially when we are working to address health inequities. My current clients are all highly mission-driven, which is my greatest motivator.
What challenges do you see organizations consistently underestimate when trying to shift from fee-for-service to value-based models?
As an actuary and analytics person, I may be biased, but the data processes for VBC contracts consistently take more time and resources than we estimate. The issues range from getting approval from data security teams, to ensuring the right population is provided, to getting consistent and accurate data on a cadence that enables insights, to agreeing on the data used for reconciliation and savings calculations at the end of the measurement period.
Another area we tend to underestimate is the time and effort involved in selling a solution to payers. Payers are large organizations with tight budget controls, and it is becoming more and more important to demonstrate a financial ROI for any vendor or solution. We have the best success when we can tell our story in a concise and data-driven way, and when we have a strong champion within the payer to promote us and help us navigate.
Personally or professionally, what might the WBL network be surprised to know about you?
My freshman year of college, I majored in piano performance, but I switched to math when I realized how difficult it would be to make a living in music with my (relatively mediocre) level of talent. I love to sing with groups, play piano and guitar, and especially love hearing and watching my family make music. My fantasy careers (if talent and training were not a barrier!) are conductor of an opera orchestra and star of a Broadway musical.
