Karan Rustagi, FSA, MAAA, joined Wakely in 2013 and works in the Denver office of Wakely Consulting Group, LLC. He specializes in risk adjustment analysis and strategy development. One of his most recent projects has been managing a state Medicaid risk transfer payment analysis. Karan has provided Medicare risk adjustment analyses for expert witness work, ensuring adjustments to the risk adjustment process followed actuarial standards of practice. As a lead actuary, he advised and helped develop several regional and national health plans with risk adjustment strategies in the ACA markets. He also assisted carriers launch Medicare Advantage products and certified MAPD bids. Karan helped several health tech start-ups understand the health insurance market and demonstrate the value of their products. Karan developed Wakely’s index rate and actuarial value pricing models. Karan has helped establish several risk adjustment models and customized models for various health plans for accurate and defensible measurements of population morbidity. Other projects include modeling the impact of consumer behavior on the Health Exchanges, pricing and reserving for commercial products, return-on-investment estimation on integrated care management programs, and predictive modeling. He assisted several national carriers launch new products and helped several regional players devise strategies to compete with dominant players. He has also assisted carriers, AHIP, and state and foreign governments understand the impact of various healthcare reform measures. Karan is a nationally-recognized and sought-after expert in all actuarial aspects of the Affordable Care Act. Karan has been a healthcare actuary since 2009.
