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Understanding Risk Under Health Reform: How Do Insurance Exchanges and Payment Reform Require New Approaches for Measuring and Managing Risk?

Date: 10/30/2013

Time: 3:30 PM - 5:00 PM

Location: 2-260R Carlson School of Management

Cost: Free


Actuarial Seminar Series

David Knutson
Senior Research Fellow, Division of Health Policy & Management, University of Minnesota

The ACA introduced market rules and risk mitigation mechanisms that, in many ways, represent novel changes to the way risk is typically understood by issuers for marketing and pricing in the individual and small group commercial insurance market. Likewise, risk based provider payment reform introduces demands for new ways to assess and predict risk for ACOs and patient centered medical homes. Do these new demands represent just another application of traditional actuarial practices or do they require new skills? This presentation will describe these new demands regarding risk assessment and prediction as well as implications for actuaries.

Currently, Mr. Knutson conducts research in the areas of insurance markets, provider payment, risk adjustment, and managed care. In 2011-12, while on leave from the university, he served as a Senior Policy and Program Analyst in the Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the US Department of Health and Human Services in Washington, DC. His work included policy analysis and regulatory review related to health care reform. In addition, he collaborated on interagency workgroups with the CMS Center for Innovation on such initiatives as the Pioneer ACO program and the Comprehensive Primary Care Initiative, and with the Center for Consumer Information and Insurance Oversight (CCIIO) on the Health Benefit Exchange Rating and Risk Adjustment Workgroup. During his tenure at HHS he has also served as the Acting Director of the Division of Health Care Quality and Outcomes in ASPE. Mr. Knutson initiated an insurance exchange agent-based micro simulation modeling project as well as videotaped over twenty-five training modules which were released to the actuarial community in February, 2013.

Previous positions include director of Health Systems Studies at the Park Nicollet Institute, senior director of provider contracting and regional expansion for two HMOs, Emergency Medical Services (EMS) and long-term care regional senior planner, and executive director of hospital and community-based mental health programs. He has served on numerous state and national advisory committees as well as many national and globally funded research projects. Mr. Knutson has a B.A. in biology and an M.S. in health economics.

This seminar is free and open to the public, RSVP is not required.

We want to thank UnitedHealth Group for its sponsorship of the UnitedHealth Group Actuarial
Scholarship Program and this seminar series.



  • Name: Jessica Haupt
  • E-mail: jahaupt@umn.edu
  • Phone: 612-624-9202
  • Sponsored by: Carlson School of Management

More information: http://www.carlsonschool.umn.edu/medical-industry-leadership-institute/index.aspx

Disability Options:

To request disability accommodations, please contact Jessica Haupt: jahaupt@umn.edu

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