Eric P. Goetsch
FSA, MAAA
Principal and Consulting Actuary
Brookfield, WI, US
Eric Goetsch is a principal and consulting actuary with the Milwaukee office of Milliman. He joined the firm in 1994.
Experience
Eric’s areas of expertise are health insurance and managed healthcare programs, including being a firm-wide leader in Medicare Advantage and Part D consulting. His client work has been in the areas of feasibility and strategic analyses, premium and capitation rate development, experience analysis, liability estimation, and other actuarial projections. He has advised managed care organizations, state government agencies, insurance companies, employers, and other organizations.
Examples of projects Eric has led include:
- Medicare Advantage and Medicare Part D feasibility analysis and bid development / support for hundreds of bids across many states, including feasibility analysis and bid development for numerous special needs plans for the dual-eligible, chronic disease, and institutionalized populations. Eric has been working with managed Medicare organizations since 1995.
- Internal Service Fund analysis, state capitation revenue allocation, and risk factor development for over 15 Michigan Medicaid Community Mental Health organizations. He has been the lead actuary for these clients since 2004.
Professional Designations
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
Education
- BS, Mathematics, Marquette University, 1993
- MS, Actuarial Science, University of Wisconsin, Madison, 1994
Publications
Read their latest work
Article
Payment reform will impact Medicare Advantage
24 February 2011 - by Patrick J. Dunks, Eric P. Goetsch, Brad Piper
The PPACA will bring significant change to the Medicare Advantage market.
Article
Medicare Advantage hierarchical condition categories: Targeting chart reviews
31 January 2011 - by Corey Berger, Eric P. Goetsch
Accurate diagnostic coding can mean all the difference to a Medicare Advantage plan.
Article
ICD-10 critical success factors: Session 5
16 March 2010 - by Eric P. Goetsch, Lisa Mattie
This fifth and final session in a five part Milliman webinar series on the 10 critical success factors (CSFs) for successful ICD 10 implementation focuses on CSFs # 9 Planning for the financial impact and #10 Leveraging for strategic opportunities..
Article
Strategies for ICD-10 take proactive approach
01 June 2008 - by Eric P. Goetsch, Lisa Mattie, Pat Zenner
Most healthcare players agree that ICD-10 implementation will be expensive and resource-intensive. That said, there are still opportunities that afford proactive organizations the chance to become industry leaders under the new system. Implementation will reverberate beyond the core payer and provider community
Article
Elevating to ICD-10: It may be one of the best things to happen to healthcare
01 December 2007 - by Eric P. Goetsch, Pat Zenner
Although most analysts would be hard pressed to equate the World Health Organization's latest version of the International Classification of Diseases and Related Health Problems (ICD) with a 1966 Clint Eastwood movie, there will indeed be "the good, the bad,