SERVICES
Health Actuarial Services
Many of our projects are unique and tailored to the business needs of the client. Acumen offers some services that other actuarial consulting firms do not, and we strive to remain a step ahead of the cutting edge. Call us today to discuss how we can work together. As a full-service shop, Acumen provides all kinds of health actuarial services to all types of clients in both the private and public sector.
PRICING—
Including product and portfolio development
Rate filings for all types of coverage
From calculating the expected average costs of specific new benefits to the aggregate future costs of entire products
REPORTING and FINANCIAL ANALYSIS of REVENUE, CLAIMS, and BUSINESS EXPENSE—
Off-the-shelf reporting packages or enhancements to existing systems
Independent analysis of current internal reporting
Recommendation for future enhancements
Benchmarking and competitive analysis
RESERVING and VALUATION—
Claims reserving and other actuarial reserves
Qualified to sign financial statements
BUSINESS REVIEW and OTHER ANALYSIS—
Feasibility studies of future business or product line expansions
Business review with respect to improving competitive position and bottom line
Strategic guidance and independent business advisory services
Service area analysis
Medical provider contracting
Assessment of savings from medical management initiatives
Medical and pharmacy cost trend
INTERNAL DEVELOPMENT—
Acumen reviews companies’ internal processes, tools, and models to assess their strengths, weaknesses, and opportunities for improvement
Acumen helps companies build the tools and processes they need to develop their internal business processes and lines of business
Readiness analysis for various aspects of commercial and gov’t. programs business
OTHER AREAS
Expert Witness and Litigation Support
Reinsurance
Pharmacy
Other supplemental benefits—dental, vision, hearing, wellness, …
PEER REVIEW of OTHER COMPANIES’ ACTUARIAL WORK
Acumen provides health actuarial consulting services in a cost-effective manner. Acumen’s owner, Daniel Bailey, FSA, MAAA, is a consulting health care actuary in West Hartford, Connecticut with 25+ years of experience in health care in positions of progressive responsibility from actuarial student to AVP, VP, and Chief Actuary. His background includes both commercial health coverage and government programs.
Acumen’s owner has filed hundreds of plans and rates under commercial health insurance coverage. He has developed and certified hundreds of Medicare Advantage bids for many companies of different types--local, regional, and national clients all over the US and its territories. Acumen works with Medicaid and CHIP as well as high risk pools. And Acumen’s actuaries have also worked extensively with self-funded coverage and medical stop loss insurance.
Acumen’s owner has been involved with managed Medicare since Medicare Risk in the mid-1990s. He developed the SOA Boot Camp course in Medicare Advantage Pricing in 2009 and has taught and led it for the past seven years. He has worked with dozens of MAOs throughout the US and territories. His consulting work ranges from hands-on technical and tactical to strategic C-suite advisement. He has provided bid work as well as portfolio and plan design to many MAOs of various types and size.
Acumen works with all commercial group sizes and funding types, fully insured and self-funded, including small group, large group, federal government, state government and municipality plans. We have many years of experience with government programs, such as Medicare Advantage, MLTC, FIDA, PACE, Medicaid, CHIP, and high risk pools. We have worked with all types of group and individual health insurance in the United States and its territories, mostly HMO and PPO comprehensive health coverage, but also pharmacy and medical stop loss.
Acumen provides expert witness actuarial services in matters pertaining to health care.
Acumen assists clients with strategy, business reviews and feasibility studies, pricing and trend, portfolio and product design & development, research and modeling, forecast and plan, financial reporting, rating systems, risk adjustment, predictive modeling, underwriting, reserving and valuation, provider analysis, and market analysis. Acumen’s actuaries have helped companies develop reporting and analytics that enable them to better manage the key drivers of their business performance and the risks underlying their contracts and enterprise. Acumen has specialized recent experience with Medicare Advantage for individual and group HMO, PPO, and SNP bids, including MLTC for Duals. Acumen has also been closely involved with health reform and helping clients prepare for the future. In addition to private health care payer clients, Acumen has worked with state governments and physician groups. We have analyzed existing regulations and proposed policy changes around essential benefits and mandates.