Frederick (Fritz) Busch
Fritz Busch is a principal and consulting actuary with the Milwaukee office of Milliman. He joined the firm in 2015.
Experience
Fritz’s experience includes over 30 years as an actuary and business leader in the insurance industry. Prior to Milliman, he was with multiple Blue plans, as well as consulting roles with Mckinsey & Co.
His commercial carrier experience includes a wide array of actuarial plan management functions, including reserving and annual statement work, trend analysis, large group pricing, ACA individual and small group pricing, forecasting, benefit plan design, and health product development.
In addition to carriers and payers, he has advised state regulators on health care reform initiatives, including 1332 waivers certifications, state public option programs, Basic Health Plan (BHP) analysis and coverage for the uninsured. Engagement deliverable in these complex initiatives included, strategic and creative thinking on model frameworks, ensuring that modeled program parameters are consistent with laws and regulations actuarial modeling of enrollment, costs and revenue sources for these health care reform proposals.
He is a leader in the Direct Primary Care space, advising employers, health systems, and DPC organizations on costs, ROI, product design, and utilization benchmarks. He has worked with third-party vendors in designing and evaluating appropriate methodologies to estimate savings from various delivery system models improvements.
He has successfully worked with a wide variety of clients, including regulators, insurance company executives, and other non-actuarial clients. He is a frequent speaker at industry and public policy meetings.
Recent client projects include:
- ACA Individual and small group, competitive analysis, market assessments and market entry strategies, forecasting and planning; ACA product development; pricing and filings; risk-adjusted profitability analysis
- Annual Statements of Actuarial Opinion
- Association Health Plan (AHP) and level-funded plan strategy, plan management, and pricing
- Modeling and support for payer’s provider contracting change impacts
- Multi-payer fee schedule parity analysis for a large hospital system
- Capitation rate development
- Public Option, State 1332 Waiver, and other state-based reform initiatives
- Savings methodology and ROI analysis; review and recommendations for healthcare third-party vendors
- Evaluation of prior authorization (PA) programs
- Co-Author, Direct Primary Care: Evaluating a New Model for Healthcare Delivery and Financing. Society of Actuaries Research, May 2020.
- Co-Author, Consumers to the Rescue? A Primer on HCHPs and HSAs Society of Actuaries Health Watch, February 2019.
- Presenter, AHIP National Conference on the Individual and Small Group Markets, 2017 and 2018.
- Co-Author, Emerging Data on Consumer-Driven Health Plans. American Academy of Actuaries Monograph, May 2009.
Professional Designations
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
Education
- BA, Mathematics, Doane College, Crete, NE, 1986
Publications