Joan Peters Ogden
I have always viewed myself as a mathematician. As an undergraduate, I took more than half my credits in mathematics and statistics. The rest of my classes were a smattering of one of everything. That breadth has proved very valuable, since as a health care actuary I need to know a little about psychology, sociology, economics, governmentÃ‰ . The list is endless.
My job is to predict the future! As a consulting actuary, I am usually called to determine how many people in a given population will develop the need for health care in a future time period (as long as up to 20 years), what kind of care they will receive, and how much that health care will cost.
I own an actuarial consulting firm, and personally consult with four kinds of clients. For insurance companies, I perform the function of an in-house actuary, assist in the conceptualization of health care insurance products, draft policy language, work with claims processing so that they pay claims according to the benefits provided, and research and model to put a price tag on the benefits (premium rate).
For large employers who provide health care benefits for their employees, I evaluate the benefit use, identify areas of misuse or abuse by the employees, and assist the employer in evaluation of and negotiation with its insurance carriers.
For hospital chains and groups of physicians, I assist in determining the right fixed price to charge for packages of services to be marketed to HMOs and other insurance entities.
For regulators and legislators who require information about the future costs and effects of legislation that they are contemplating, I will work on legislative language and evaluation of expected costs and the effect of those costs on behavior. I have been deeply involved in the whole health care reform issue, particularly in my own state.
My predictions, regardless of the client, are based on vast data banks, both those I have developed and others into which I can insert changes in the practice of medicine and the development of new techniques and drugs. I might develop a pricing model that would encompass 20,000 separate calculations for long-term care insurance, or work with a project much more simple, such as the use of a particular pharmaceutical during 1996 among an employed population. My mathematical background is always being called upon for skills in logic, the ability to recognize patterns and anomalies, and the ability to organize large amounts of technical data and to extract needed information. As a consultant, I never know at the beginning of a day what I will have done by the end of the day, but I know it will be interesting and challenging, and will keep me on my toes.