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Adrian L. Clark, FSA, MAAA

Principal & Consulting Actuary
Seattle, WA, US

Tel: +1 206 5045844

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Professional Designations

  • Fellow, Society of Actuaries
  • Member, American Academy of Actuaries

Education

  • BA (with distinction), Economics, Mathematics and Philosophy, University of Colorado – Boulder.

Current Responsibility

Adrian is a principal and consulting actuary with Milliman. He joined the firm in 2007.

Experience

Adrian’s expertise is in group healthcare, with an emphasis on health plan pricing and predictive modeling. Types of clients he has supported include:

  • Hospitals and physician groups
  • BCBS and traditional insurance companies Managed care organizations (HMO, PPO)
  • Large and small employer groups
  • Medicare Advantage plan sponsors
  • Medicaid, low-income, and uninsured programs
  • Other government programs (e.g., veterans)

His consulting assignments have included:

  • Assisting providers negotiate capitation rates
  • Provider contract analysis
  • QHP pricing, rate filing and review
  • Individual, small and large group health plan pricing
  • Feasibility studies for entering new markets, such as heath exchanges, Medicare and Medicaid.
  • Review, implementation and customization of risk adjustment algorithms
  • Calibrating risk adjusters for commercial populations
  • Medicare Part C and Part D bid support
  • Commercial payer utilization benchmarking

Product development

  • Lead Researcher on loosely managed benchmarks for Milliman’s Commercial Health Cost Guidelines (HCG)
  • Lead Developer for Milliman’s Part D Experience Summary Tool (PEST)
  • Lead Developer for Milliman’s Risk Adjustment Tool (RAT)

Publications

  • Risk score impacts of the Medicare Advantage 2018 RxHCC risk score model update (with David Koenig). Milliman Insight June 2017
  • Design and Implementation Considerations of ACA Risk Mitigation Programs (with Jim O’Connor). Society of Actuaries Research Report
  • The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries (with Gabriela Diequez and Brad Piper). Issue 69 May 2012 Health Watch – Society of Actuaries

Industry presentations

  • “Medicare Advantage Risk Adjustment: Past, Present and Future,” Society of Actuaries Health Meeting June 2017.
  • “Morbidity-adjusted Hospital Utilization Benchmarks: A Case Study,” Milliman Client Forum. November 2014.
  • “Predictive Modeling in Health: Tips from the Trenches,” Society of Actuaries Annual Meeting. October 2013.
  • “Predictive Modeling In Health Insurance,” Seattle Actuarial Club Meeting. October 2012
  • Work at Milliman

    • “I was offered a chance to come in, shake things up, create something."
    Work at Milliman