John Price, FCA, MAAA
John Price is a seasoned veteran of the managed care industry. He has held executive level positions with a number of top health care organizations such as Kaiser Permanente, Intermountain Healthcare, Blue Cross/Blue Shield Plans, Aetna and United HealthCare. John joined Axene Health Partners, LLC in 2004 and his executive and business strategy experience are valuable tools for AHP clients.
John’s extensive health actuarial experience spans more than 40 years and includes:
- Independent consulting services to select health care providers and health plan clients including medical groups, managed care organizations (MCO’s), HMOs, MA/PD Plans, ACOs, PPOs, long term care (LTC) plans, and health insurers;
- Designing provider networks and managing financial arrangements under commercial insured and self-funded plans, as well as other government programs such as FEHBP, Medicare, Medicare Advantage, Medicaid, and Tricare;
- Providing health actuarial expert witness resource supporting dispute resolution and litigation;
- Designing return on investment (ROI) and comparative cost performance models for clients’ health care initiatives including disease management programs, value-based health care programs, wellness programs, health care provider networks, and innovative health benefits aligned with provider payment incentives;
- Team lead actuary for a comprehensive long term care program, actively marketed to select individuals and sponsored by an ERISA type trust;
- PPACA issues and related business strategies, evaluation and management of risk, reinsurance and stop-loss arrangements;
- Self-funded employer plans, large employer groups, multiemployer trusts, small group pools, and individual products;
- Designing and implementing health plan pricing and underwriting processes and systems, managing relationships with insurance regulators and complex product filings;
John has several professional designations including: Member of the American Academy of Actuaries, Fellow in the Conference of Consulting Actuaries and received the designation Qualified Health Actuary from the Society of Actuaries.
He is deeply committed to the actuarial community and has participated in the Actuarial Standards Board Health Committee. He is an active member of the Adaptive Business Leaders, a California forum of health industry and technology leaders.
John holds a bachelor’s degree from the University of Washington with an emphasis in mathematical statistics.