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Joel Hoffman, F.C.A, A.S.A., M.A.A.A.

Principal
Reden & Anders, Denver, CO

Joel Hoffman is a Principal in the Denver office of Reden & Anders and shares responsibility for the firm’s national health care actuarial consultancy. He has more than eighteen years of actuarial experience in all aspects of health insurance and managed care and has been involved in health care actuarial and consulting engagements across the country. His responsibilities have focused on both the financial and clinical aspects of health care, with direct experience in product development and plan design, pricing and capitation, provider reimbursement, clinical economics, disease and medical management, outpatient prescription drugs and other health care carve-out programs, reinsurance, and financial reporting. Hoffman advises clients on strategy, strategic partnerships and alliances, risk, contracting, rating, and the financial, clinical and operational elements of performance measurement, validation, and enhancement.

His recent consulting efforts have concentrated on financial and clinical outcomes measurement and the validation of initiatives all across the continuum that seek to improve health care delivery and finance. He has advised care and disease management organizations—as well as health care vendors that provide services such as home care, home infusion or outpatient rehabilitation services, pharmacy benefit management firms, managed care organizations, hospitals and physician organizations. More specifically, he helps them analyze program costs and treatment modalities to measure results and validate the impact their efforts have had on net medical resource consumption and net health care expenditures.

Hoffman designs, contracts, monitors, and audits financial and clinical outcomes measurement methodologies. He also assesses and validates the efficacy of organizations that seek to enhance health care outcomes. He assists with outcomes reporting and at-risk revenue recognition as they relate to financial statements, and he helps optimize risk and effectively use the reinsurance markets. Recently he has been asked by the Disease Management Association of America to participate on a team of industry experts charged with developing industry standard outcomes measurement methodologies.

He also consults with HMOs and other managed care organizations, health care providers, single service plans (e.g., mental health/chemical dependency carriers or prescription benefit management firms), and insurance companies. He has extensive experience with the delivery and finance of health care services under both private and public sector products covering the commercial, Medicare, and Medicaid populations.

Hoffman is a recognized leader in the managed care arena known for his expertise in disease management and predictive modeling. His studies measuring the efficacy of disease management programs have been published in leading journals, and he is frequently quoted by the media and is a regular speaker at major industry events.

Contact: (215) 327-4930