JAMES MICHAEL ROBINSON

Transcription

1 JAMES MICHAEL ROBINSON Senior Scientist Center for Health Systems Research and Analysis University of Wisconsin - Madison 610 Walnut St., Rm Madison, WI / (voice) 608/ (facsimile) Jim_Robinson@chsra.wisc.edu EDUCATION High School: Tomahawk High School, Tomahawk, WI 1973 Undergraduate: Univ. of Wisc. - Madison B.B.A. - Actuarial Science 1977 Postgraduate: Univ. of Wisc. - Madison Ph.D. - Business/Statistics 1989 PROFESSIONAL DESIGNATIONS Fellow, Society of Actuaries 1979 Member, American Academy of Actuaries 1981 EMPLOYMENT HISTORY 8/96 to present Senior Scientist, Center for Health Systems Research and Analysis, University of Wisconsin - Madison, statistical and financial analysis and modeling of long-term care. 5/94-7/96 Senior Consultant, Coopers & Lybrand L.L.P. - life and health insurance actuarial consulting, specializing in long-term care coverage, to insurance companies, state governments, and insurance regulators. 1/88-5/94 Assistant Professor, Dept. Actuarial Science, Risk & Insurance and Dept. Quantitative Analysis (Business Statistics) 5/85-12/87 Consulting Actuary (part-time), Madison National Life Ins. Co. 8/84-12/87 Lecturer, Dept. Actuarial Science & Insurance / Dept. Quantitative Analysis - taught life insurance mathematics, interest theory, and mathematical analysis for MBA's. 6/77-8/84 Actuary, Sentry Life Insurance Company, 1800 North Point Dr., Stevens Point, WI --- August, 2003 Page 1

2 4/83-8/84 Financial Actuary, Domestic Life and Health Ins. Operations - responsible for actuarial aspects of annual statement preparation and certification; reinsurance analysis (ceded and assumed); direct staff of two FSA's and an ASA; total staff of 7 actuarial personnel and 2 technicians; responsible for life and health actuarial program, i.e. recruiting, job descriptions, salary administration guidelines, etc. 8/81-4/83 Associate Actuary, Individual Product Control - Responsible for actuarial aspects of individual product development and control, including life, health, and annuity contract forms; staff of 1-2 FSA's, 1-2 ASA's, 2-3 actuarial students. 2/80-8/81 Senior Actuarial Assistant, Individual Product Control - Responsible for development and maintenance of pricing assumptions, techniques, and related software analysis tools for individual life, health, and annuity product forms; staff of 1-2 actuarial students. 6/77-2/80 Actuarial Student (Actuarial Technician through Actuarial Assistant), Financial Actuarial Dept. - completed final 4 actuarial exams; responsible for actuarial aspects of individual life, health, and annuity financial reporting for Sentry Life and two subsidiary L&H companies; no staff. SAMPLE LONG-TERM CARE EXPERIENCE - Current responsibilities include a) analysis and modeling of Wisconsin Medicaid nursing facility reimbursement methodology, b) implementation of OASIS-based quality indicator calculations and reporting for home care agencies, c) analysis of capitation methods for the Program for All-Inclusive Care of the Elderly (PACE), and, d) a variety of support roles on projects dealing with long term care provider quality of care, reimbursement and management issues. - Member of the 2000 Technical Review Panel on the Medicare Trustees Reports. - Performed analysis of Medicare capitation rates under the Program for All- Inclusive Care for the Elderly (PACE). - Performed modeling and projection analysis of Georgia's Medicaid nursing facility reimbursement system to assess feasibility of implementing case-mix adjustment. Results documented in "Final Report: Georgia Medicaid Nursing Home Case Mix Evaluation Project," issued by the Center for Health Systems Research and Analysis, University of Wisconsin - Madison, June Participated in a follow-up analysis as documented in "Final Report to the Georgia Department of Medical Assistance, Issues in the Development of an August, 2003 Page 2

3 Integrated, Capitated, Managed Long-Term Care Network," issued by the Center for Health Systems Research and Analysis, University of Wisconsin - Madison, October Most recently, reconstructed the case mix model as documented in Georgia Nursing Home Case Mix Project: Modeling Component, issued through a subcontract with the University of Missouri at Kansas City, December Performed modeling and projection analysis of expenditures for a pilot program in Texas to combine Medicaid / Medicare funding under a coordinated system of managed care for dually-eligible elderly and disabled adults. Authored "Texas Long-Term Care Integrated Model, Projection and Capitation Model," November 5, Performed several long-term care insurance pricing and product development analyses for private insurance companies. ( ongoing) - Performed several actuarial reviews of long-term care insurance reserves for a variety of Coopers & Lybrand audit clients. ( ) - Performed an extensive actuarial review of long-term care insurance policies in the liquidation of American Integrity Insurance Company for the National Organization of Life and Health Guarantee Associations. ( ) - Member, Society of Actuaries Long-Term Care Insurance Valuation Methods Task Force. ( ) Authored "Chapter 3, Noninstitutional Tables," in "Final Report of the Society of Actuaries Long-Term Care Insurance Valuation Methods Task Force," Transactions of the Society of Actuaries, To Be Published. - Provided pricing support for National Association of Insurance Commissioners Long-Term Care Task Force. ( ) - Performed actuarial analysis of proposed Washington state long-term care benefit program for the Committee for Affordable Health Care. Co-authored "Report to the Committee for Affordable Health Care, Inclusion of Long-Term Care Benefit in Uniform Benefit Plan, State of Washington," October 17, Consulting actuary to Wisconsin Department of Health and Social Services - pricing prototype long-term care insurance under a grant from the Robert Wood Johnson Foundation. Authored "Pricing for Long-Term Care Insurance," a report to the Wisconsin Department of Health and Social Services, December, LONG-TERM CARE PRESENTATIONS - Presented American Academy of Actuaries LTC Insurance Practice Note in Practice with Amy Pahl and Darrell Spell in Vancouver, BC, June, Presented Sources of Variation in PACE Site Financial Risk Part 2 at the August, 2003 Page 3

4 2002 National PACE Association Conference in Quincy, MA, October, Presented Dissecting the Cost of Product Design Decisions with Amy Pahl and Claude Thau at the 2002 LOMA-LIMRA-Milliman Disability Income & Long-Term Care Insurers Forum in Orlando, FL, September, Presented The Next Frontier: Measuring Provider Quality with Robert Bua at the 15th Private Long Term Care Insurance Conference in Miami, FL, August, Presented Sources of Actuarial Data with A. Schmitz, at the 2001 Intercompany LTC Insurance Conference in Miami, FL, January 22, Presented Home Care Assessment, Quality Indicators, Classification and Medicare Payment with Philip Cotterill, at the 2000 Case Mix Reimbursement and Quality Assurance Conference in Madison, WI, May, Presented Medicare Upper Payment Limit at the 2000 Case Mix Reimbursement and Quality Assurance Conference in Madison, WI, May, Presented Nursing Home Health Status and Care Setting Transitions with Greg Arling at the 2000 Case Mix Reimbursement and Quality Assurance Conference in Madison, WI, May, Presented The Program for All-Inclusive Care of the Elderly (PACE): Eligibility and Medicare Cost Analysis with S. Karon, July 20, Presented to the Wisconsin Department of Health and Family Services. July 20, 1999.Presented A Clinician's Introduction to Resource Utilization Groups (RUG's) and Case Mix Reimbursement at the 1998 National Symposium on the Quality of Life in America's Nursing Homes" Madison, WI, May 19-20, Presented The Medicare SNF Prospective Payment System (PPS) - How Will It Work? at the 1998 National Symposium on the Quality of Life in America's Nursing Homes" Madison, WI, May 19-20, Chaired Modeling the Impact of Implementing a Case Mix Reimbursement System, Session T5, and follow-up Session T11 at the 1997 National Case Mix Reimbursement and Quality Assurance Conference in Cleveland, OH, September 21-24, Presented Modeling Long-Term Care Using a Multi-State Approach, with Bruce Jones at the Society of Actuaries Spring Meeting in Montreal, June 19-20, Presented Case Mix: An Overview, with S. Karon. Presentation to the Wisconsin Association of Homes and Services for the Aging Health Issues Committee, Madison, WI, February 26, August, 2003 Page 4

5 - Presented "A Long-Term Care Status Transition Model," at the 1996 Bowles Symposium on The Old-Age Crisis: Actuarial Opportunities, September 1996, at Georgia State University. - Presented "Using Data Effectively to Establish Capitation Rates," at the National Association of Home Care Regional Conferences, Presented "Long-Term Care Valuation Issues: The Challenges - Theoretical and Practical," at the Society of Actuaries Regional Meeting, April, 1992, in Las Vegas. OTHER ACTUARIAL EXPERIENCE - Various studies of mortality and lapsation for individual insurance products - Expense studies to establish pricing margins for individual insurance products - Development of pricing assumptions and techniques for individual insurance products, including traditional life and annuity contracts, flexible premium annuities, retired lives reserve and Section 79 products, indeterminate premium permanent and term life insurance, universal life insurance, and various ancillary benefit forms - Individual insurance product development, design, and implementation, with exposure to contract writing, state filings, administrative systems considerations, underwriting guidelines, design of policy illustrations, establishment of commission rates and other sales compensation, financial reporting implications, and income tax analysis - Financial analysis of all L&H product lines, including individual life, health, & annuities, group life, health, & pensions - Establishment and control of all L&H reserves (mostly statutory - some GAAP), including policy reserves, claim reserves, experience return reserves, deposit liabilities, contingency reserves, etc. Certified actuarial aspects of 1984 Annual Statement and several quarterly statements. - Developed and implemented year-of-investment investment income allocation technique and studied impact upon such areas as pricing and interest crediting decisions. - Developed and implemented pricing software and policy illustration software for Sentry's first universal life policy. - Served on committees which... - studied Sentry Complex sales compensation. - selected a new individual product administrative software package. August, 2003 Page 5

6 - studied the impact of new FIT legislation. - Reviewed credit insurance rate regulations in Wisconsin and analyzed proposed new regulations. - Taught a variety of actuarial and business statistics courses at the University of Wisconsin - Madison. - Math 303, The Theory of Interest and Life Insurance (11 times) - Business 565, Life Insurance (once) - Business 660, Interest Theory (once) - Business 661, Life Contingencies I (twice) - Business 662, Life Contingencies II (twice) - Business 663, Construction of Mortality Tables and Graduation (3 times) - Business 664, Risk Theory (once) - Business 704, Intermediate Business Statistics (3 times) - Business 714, Mathematical Analysis for Business I (10 times) - Business 777, Advanced Statistical Methods I (twice) - Business 778, Advanced Statistical Methods II (once) - Variety of actuarial consulting assignments - Actuarial aspects of the state examination of Northwestern Mutual Life Insurance Company - Occasional statistical advice to audit and tax functions of Coopers & Lybrand - Participate in Coopers & Lybrand In-Control Services audit of insurance sales practices of major life insurance company PROFESSIONAL ACTIVITIES - Society of Actuaries task force to review and implement new life insurance mathematics textbook on Society exams - Society of Actuaries examination committee for Part 4 (Life Contingencies) and Part 5 (Risk Theory) - Author of a study note on moment generating functions for Society of Actuaries Part 5 examination - Past President of Wisconsin Actuarial Club - Past Supervisor of Society of Actuaries associateship examinations in Madison, WI August, 2003 Page 6

7 - Past coordinator of Society of Actuaries exam review sessions at University of Wisconsin - Past chairman, academic and business instructor, Society of Actuaries Course Intensive Seminar on Applied Statistics (regression and time series topics) - Past extended case study instructor, Society of Actuaries Course 7 Applied Modeling (Dec and June 2002) DISSERTATION TOPIC "Modeling, Inference and Forecasting Techniques for the Analysis of Non-Life Insurance Claim Reserves," 1989, Univ. of Wisconsin. OTHER PUBLICATIONS AND PRESENTATIONS Robinson, J. The AAA Practice Note in Practice Part 1. Society of Actuaries LTC Insurance Section Newsletter, April, Robinson, J. The Role of Actuaries in Non-Traditional Long Term Care Insurance. The Actuarial Digest, October, Robinson, J. Credibility Theory for the Health Insurance Actuary: The Need for an Inter-Company Experience Study. Society of Actuaries LTC Insurance Section Newsletter, December, Presented Credibility Theory for the Health Insurance Actuary at the University of WI actuarial seminar, November, Authored case studies in appendix of Introduction to Credibility Theory, 3rd Edition, by Thomas Herzog, Actex Publications, Robinson, J. and S. Karon. Modeling Medicare Costs for PACE Populations. Health Care Financing Review, Spring Harrington, C., Zimmerman, D., Karon, S.L., Robinson, J., and Beutel, P., "Nursing Home Staffing and its Relationship to Deficiencies," The Journal of Gerontology: Social Sciences 55B(5):S1-S10, Instructor for Society of Actuaries Credibility Theory Seminar, in Chicago, IL, November, Discussion of "Maximum Likelihood Alternatives To Actuarial Estimators of Mortality Rates," by James D. Broffitt, Transactions of the Society of Actuaries, Vol. 36, 1984, p August, 2003 Page 7

8 Discussion of "Measuring The Interest Rate Risk," by Paul R. Milgrom, Transactions of the Society of Actuaries, Vol. 37, 1985, p Presented "A Stochastic Model for Non-Life Insurance Claim Incurral, Accrual and Reporting," at the 1988 Joint Statistical Meetings of the American Statistical Association and the Biometric Society, August 23, 1988, in New Orleans. Presented "The Kalman Filter From A Bayesian Point Of View," at the Regional Meeting of the Society of Actuaries, April, 1989, in Chicago. Presented "Non-Life Insurance Claim Incurral, Accrual and Reporting," at the 1990 Actuarial Research Conference, University of Western Ontario, London, Ontario, Canada, August, Presented "Analysis and Extension of the Smoothness Component of Whittaker- Henderson Graduation," at the 1992 Joint Statistical Meetings of the American Statistical Association and the Biometric Society, August, 1992, in Boston. August, 2003 Page 8