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David Koenig

FSA, MAAA
Principal & Consulting Actuary
Seattle, WA, US

David Koenig is a principal and consulting actuary with the Milliman Seattle Health Practice. He has been with the firm since 2010.

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Experience

As a healthcare consultant, David works primarily with the Medicare and Medicaid markets. His clients include insurance companies and provider groups.

David’s experience as a healthcare consultant includes:

  • Medicare Advantage Part C and Part D bid preparation and support
  • CMS-HCC risk adjustment calculation, including Part C (both ESRD and non-ESRD) and Part D models
  • Provider risk-contracting support
  • Year-end statements of actuarial opinion and reserving
Publications

Read their latest work

Article

Medicare Part D risk and claim cost changes with the Inflation Reduction Act

18 January 2023 - by Rebecca Gergen, Zeb Leciejewski, David Koenig, Kevin Pierce
Medicare Part D plan sponsors need to understand how liabilities will change and evaluate potential strategies due to impact of the Inflation Reduction Act.
Video

Webinar: Follow the money: Your guide to Medicare financial performance

10 August 2022 - by David Koenig, Kevin Pierce, Shyam Kolli, Brian Regan
Join our Milliman consultants as they explore Medicare Parts C & D from a financial perspective, highlighting recent financial performance, discussing key CMS files health plans use to monitor financials, considering cash flows including various settlements, and offering insights on risk-based capital considerations.
Article

Impact of COVID-19 on 2023 MAO risk score projections

04 November 2021 - by David Koenig, Rob Pipich, Michael J. Polakowski
Deferred or avoided care in 2020 can cause lower risk scores and revenue in 2021, which needs to be considered when developing projections for 2023
Article

COVID-19’s impact on MA risk scores: How insurers can protect themselves

11 August 2020 - by David Koenig, Rob Pipich, Michael J. Polakowski
Medicare Advantage organizations face unique challenges during the COVID-19 pandemic.
Article

Have we reached parity between Medicare Advantage RAPS and EDS risk scores?

31 July 2020 - by David Koenig, Emily Vandermause, Rebecca Gergen
With 2022 just around the corner, it is important that Medicare Advantage organizations understand the expected impact of the Encounter Data Processing System as the single source of diagnoses for calculating risk scores and the impact this transition may have on their revenue.
Article

Model change impact on the Medicare Advantage 2020 RxHCC risk scores

23 May 2019 - by Adrian L. Clark, David Koenig
This paper summarizes the changes in member risk scores resulting from the revised Medicare Part D risk score model for payment year 2020.
Article

Medicare Advantage’s transition from RAPS to EDS risk scores: 2017 impact

09 February 2018 - by Deana Bell, David Koenig, Charlie Mills
In 2017, many changes came to Medicare Advantage risk adjustment as the transition continued from Risk Adjustment Processing System data to Encounter Data System data.
Article

Risk score impacts of the Medicare Advantage 2018 RxHCC risk score model update

06 June 2017 - by Adrian L. Clark, David Koenig
The Centers for Medicare and Medicaid Services finalized a Part D risk score model for payment year 2018, and the impact will vary based on demographics.
Article

Impact of the transition from RAPS to EDS on Medicare Advantage risk scores

13 January 2017 - by Deana Bell, David Koenig, Charlie Mills
The transition to Encounter Data System-based risk scores will have a significant effect on Medicare Advantage organizations in payment year 2016 and future years.
Article

Medicare Advantage and the Encounter Data Processing System: Be prepared

15 September 2016 - by Deana Bell, David Koenig, Charlie Mills
During the transition to using Encounter Data System (EDS) data files, Medicare Advantage organizations must be knowledgeable about EDS, understand the impact of the transition on revenue, and monitor and review EDS submissions closely to ensure their revenue will not be negatively affected.