Adrian L. Clark
ASA, FSA, MAAA
Principal & Consulting Actuary
Seattle, WA, US
Adrian Clark 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
- Other government programs (e.g., veterans)
His consulting assignments have included:
- Assisting providers in negotiating capitation rates
- Analyzing provider contracts
- Conducting QHP pricing, rate filing, and review
- Pricing individual, small, and large group health plans
- Conducting feasibility studies for entering new markets, such as heath exchanges, Medicare, and Medicaid.
- Reviewing, implementing, and customizing risk adjustment algorithms
- Calibrating risk adjusters for commercial populations
- Providing Medicare Part C and Part D bid support
- Performing 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 and Presentations
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
Professional Designations
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
Education
- BA (with distinction), Economics, Mathematics, and Philosophy, University of Colorado – Boulder
Publications
Read their latest work
Article
Independent review of Wider Circle's methodology for quantifying financial and healthcare utilization impact of the Connect for Life program
14 June 2023 - by Austin Barrington, Adrian L. Clark, Meng Sun, Sam Yih
We review one company’s approach to quantifying the potential impacts of its community-focused healthcare program.
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
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.