Healthcare reform: Actuarial Problems and Solutions

Speaker: Hans Leida, Milliman

Date & Time:

Wednesday, November 12, 2014
7:30 PM - 8:30 PM


Owens Science Center's 3M Auditorium (OWS 150)

Hans Leida, Milliman

Abstract: In 2014, the most disruptive—or transformative, depending on your point of view—provisions of the Affordable Care Act (ACA) took effect. This has plunged the U.S. healthcare system, which makes up over 1/6 of our economy, into a turbulent transitional period.  Why is healthcare so expensive?  How have actuaries modeled health insurance risks in the past, and what new techniques are needed as insured populations reshuffle in response to exchanges, subsidies, and mandates? This lecture will answer some of these questions, starting with an overview of pre-ACA healthcare markets and spending in the U.S.  I will also give an overview of how some of the various pieces of the ACA are supposed to work from an actuarial perspective, with some comments on how things are playing out in Minnesota.  Finally, I'll discuss recent initiatives in the health actuarial community to develop new tools using ideas from complexity theory, agent-based modeling, and other predictive models.

Biographical information: Dr. Hans Leida PhD, FSA, MAAA is a principal and consulting actuary with the Minneapolis office of Milliman. He joined the firm in 2006. Hans works in the health insurance area. He has consulted to insurance companies, Blue Cross Blue Shield plans, HMOs, government health programs, and employers. Recently, he has been working on individual and small group health insurance rate filings under the Affordable Care Act’s healthcare reforms. In 2007, he co-authored a paper for America’s Health Insurance Plans (AHIP) on the impact of guaranteed issue and community rating laws adopted by certain states in the 1990s. That paper has been widely cited with the advent of federal healthcare reform, including in amicus briefs presented to the U.S. Supreme Court.

Hans also has significant experience with risk adjustment and predictive modeling of healthcare costs. He was the lead developer of the prescription-drug-based risk adjuster included in the Milliman Advanced Risk Adjusters (MARA) software product. He has also performed firm-level research on the new federal ACA risk adjustment model that will take effect in 2014. He got his PhD in Mathematics from the University of Wisconsin, and was the recipient of a University of Wisconsin Graduate Research Award, a National Science Foundation VIGRE Fellowship, and a National Science Foundation Graduate Research Fellowship.

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