Jeff Adams has 30 years of experience as a health actuary including the last eight years as an independent health actuarial consultant. He is a Member of the American Academy of Actuaries and an Associate of the Society of Actuaries. Jeff is a creative visionary and, in addition to his substantial actuarial skills, is familiar with many of the issues facing our health care system and working with others on solutions to resolve these issues.
Jeff is a 1982 graduate of Rochester Institute of Technology with a Bachelor of Science degree in Applied Mathematics with a minor in Statistics. His college education and experiences have helped in his work, allowing him to understand not only the details of the mathematical formulae but the importance of fully understanding the scenario being analyzed and strengths and weaknesses of the methodologies being used.
Jeff spent the first 10 years of his career, from 1983 to 1993, at insurance companies, where he learned the fundamentals in health actuarial science and the operations of insurance companies. Four years out of college, in 1987, Jeff became supervisor in the Actuarial Department at Blue Cross Blue Shield of Rochester. In his six years at the plan Jeff helped lift Blue Shield of Rochester from its precarious financial position. In 1989 Jeff went to State Mutual in Worcester, MA (now Allmerica Financial) to take advantage of its actuarial study program and obtained his designation in 1992. While at State Mutual he was in charge of pricing, including rewriting the company group rating manual.
In 1993 Jeff left the insurance world for the consulting world at Deloitte in downtown Manhattan. He spent eight years at Deloitte performing various actuarial functions such as helping payor clients in pricing and pricing model development, serving as actuary for several client health insurance funds, assisting providers in analyzing proposed contracts from payors, performing postretirement medical liability valuations, reviewing premium rate renewals on behalf of employers, performing 10 and 30 year financial forecasting, and assisting the Deloitte auditing staff review clients' health actuarial accruals.
In December 2000 Jeff left Deloitte to serve as Vice President and Chief Actuary for what had been his biggest client, HealthNow, parent company of Blue Cross and Blue Shield of Western New York and Blue Shield of Northeastern New York. He was in charge of the actuarial and underwriting areas and was also put in charge of the development of the data warehouse for a portion of his time at HealthNow. Jeff played a critical role in helping HealthNow triple its surplus reserve while increasing membership. Surplus levels had been below levels required by the State of New York prior to Jeff's arrival. He worked with other departments within the organization to develop processes that would help gain control over various areas of spending and to hold departments accountable for the financial impact of various initiatives, such as new procedures and fitness programs, while ensuring that all costs were included in budgeting, financial statement analyses, and rate calculations. During his tenure at HealthNow the consulting fees for the Actuarial Department were reduced from over a million when he started to zero by the time he left. The Actuarial Department budget did not increase in the four-and-a-half years he was there. Both the quantity and quality of output from the Actuarial Department increased substantially as did the scores from the Actuarial Department's annual Customer Satisfaction Survey, started by Mr. Adams in an attempt to improve the department productivity and reputation. His department became arguably the fastest in the country in producing accruals for the monthly financial statements. He also played a major role, along with head of Finance Chris Leardini and Actuarial Analyst Amin Serehali, in developing a claims cost by day of the week analysis which substantially increased the accuracy of claims estimation and trend analysis. Part of that study included estimation of the impact of substantial amounts of snow on health care costs.
Jeff left HealthNow in 2005 and has been working on his own as a health actuarial consultant since. His major client work includes pricing, underwriting, and analysis of the impact of health care reform. As part of his pricing assignments Jeff produced a regression model that was able to determine factors not currently included in trend analysis that would impact trend levels, such as historic hospital occupancy percentages and the number of physicians.
Jeff is currently in several workgroups of the American Academy of Actuaries. Many are related to health care reform but one is a workgroup set up to find solutions to efficiency and quality issues inherent in our health care system. Any suggestions on improvements in our health care system are welcome.
Early in his career, Jeff was diagnosed with Retinitis Pigmentosa. Although legally blind, Jeff is able to perform high level actuarial work through the use of various table and portable viewing machines.
Jeff is also currently writing a book entitled The Intended Addiction which will be a fictional story about issues in our health care system. This book is scheduled to be released in the near future.