Case Study

Structuring VBC-Native Reinsurance to Unlock Capital and Stabilize Specialty Risk

How a Leading Post-Acute Care Organization Optimized Risk Transfer with Bammo Shield™

January 2026

Executive Summary

A national leader in post-acute value-based care sought to stabilize specialty risk exposure across multiple markets while preserving growth flexibility.

Working in partnership with executive leadership, finance, medical economics, and legal teams, Bammo Shield™ structured a customized provider excess-loss program designed specifically for their payer contract in value-based care arrangements across several markets.

The result:

  • Claim-level and aggregate protection across specialty VBC contracts
  • ~200K+ in covered membership across several markets
  • ~$150M in claims covered under risk
  • Premium structured at less than 1% of total claims exposure for a highly tailored policy aligned to the client’s specific risk profile, incorporating both aggregate and specific coverage, with the opportunity for premium refund based on favorable claims experience.
  • Meaningful capital unlocked by transferring downside volatility to A-rated reinsurance partners
  • Integrated actuarial performance tools and a centralized claims reconciliation portal

This engagement demonstrates how VBC-native reinsurance infrastructure can provide stability, capital efficiency, and strategic flexibility.

The Challenge

The organization faced several structural realities common in specialty VBC:

  • Concentrated claim volatility in high-acuity post-acute populations
  • Year-over-year performance variability driven by episodic spikes
  • Capital reserve constraints tied to downside exposure
  • Increasing need for clarity around risk appetite and retention strategy
  • Unable to identify a partner with the specialized market expertise, value-based care experience, and risk capacity required to support their program objectives

The Approach

1. Risk Architecture & Appetite Design

Paramean conducted actuarial analysis to:

  • Quantify claim-level and aggregate exposure
  • Model retention scenarios across multiple markets
  • Align reinsurance attachment points with organizational risk tolerance
  • Design downside corridors optimized for VBC specialty risk

This process involved close coordination with the organization’s Finance, Medical Economics, Legal, and Executive Leadership.

2. Customized Provider Excess-Loss Program

Bammo Shield structured a VBC-native policy including:

  • Specific claim-level excess protection
  • Aggregate stop-loss coverage
  • Cross-market exposure alignment
  • Insurance-backed reinsurance capacity

Coverage design supported all components of their crafted deal with the payer across the various markets, taking into consideration their care model and market trends.

3. Integrated Infrastructure

Beyond coverage, the organization gained:

  • Free Trial and reduced-cost subscription to Paramean actuarial performance tools for real-time performance monitoring
  • Integrated policy issuance, premium collection, and claims submission and reconciliation processes.

One system. One operating framework.

Conclusion

Bammo Shield™ provides VBC-native risk protection infrastructure, integrating actuarial intelligence, customized underwriting, and institutional reinsurance capacity.

For this post-acute provider, the result was:

  • Stabilized specialty risk
  • Optimized capital strategy
  • Institutional-grade protection
  • Integrated financial risk management

Ready to architect your VBC risk strategy?

Discover how Bammo Shield™ can design a customized protection framework aligned to your risk appetite and capital goals.

Schedule a Risk Review

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