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David Axene

David Axene

David Axene started Axene Health Partners in 2003 after a successful consulting career at Ernst & Young, LLP and Milliman & Robertson, Inc. Mr. Axene is an internationally recognized health consultant providing consulting services to all types of health care organizations including health plans(HMOs, PPOs, managed care plans, BlueCross Blue Shield plans, insurance companies, etc.), healthcare providers (hospitals, medical groups, ancillary providers, etc.), various governments and government programs (federal, state and local, international, Medicare, Medicaid, CHAMPUS, social systems), employer health benefit plan sponsors, healthcare technology companies, medical device and technology suppliers, etc.

Axene is recognized as a strategist and thought leader. At Ernst & Young, he was responsible for the firm’s health actuaries. He was an Equity Principal with the well known actuarial firm Milliman & Robertson, Inc. where he led their healthcare management consulting activities, including founding their Care Guidelines division. Prior to beginning his consulting career in 1978, he held several positions in the insurance industry specializing in the health insurance area.

Axene is a frequent speaker and writer on healthcare issues. He is a Fellow of the Society of Actuaries, a Chartered Enterprise Risk Analyst, a Fellow of the Conference of Consulting Actuaries, and a Member of the American Academy of Actuaries. He previously served as Chair of the Society of Actuaries Health Section Council and the Entrepreneurial Actuaries Section. He is a certified ARIAS-US arbitrator.

In addition to his actuarial credentials, Mr. Axene earned an MS degree in Applied Mathematics from the University of Washington, and a BS degree in Physics and Engineering from Seattle Pacific University.

Mr. Axene serves on multiple non-for-profit Boards including Azusa Pacific University.

Mr. Axene is married and has three married children and soon to be eight grandchildren. Mr. Axene and his wife reside in Southern California.

Recent Articles by David Axene

How to Save Individual ACA Market

Since its passage, the Affordable Care Act (i.e., ACA) has been a controversial law. From the time of its passage in March 2010 until U.S. House and Senate Republicans began their efforts to repeal and replace the ACA in the spring of 2017, support for the law has never exceeded 50%. The ACA’s lack of […]

What Makes U.S. Healthcare Different?

We in the U.S. spend a lot on healthcare. Whether expressed as the cost per service, the cost per person or as a percentage of the gross domestic product, the high cost of healthcare is well documented. While solutions to this situation have been suggested for many years, the expensive reality continues. Is it possible […]

Progress Report on ACA After 9 Months

Nine months into it and getting ready for the next go-round, I thought it might be beneficial to take a look back and see what progress has been made on the Affordable Care Act.  There are many perspectives from which to evaluate the situation, and many will vary in their assessment. This article attempts to […]

New Confusion on ACA and Healthcare Reform

Recent events have added a layer of confusion for healthcare reform that needs to be resolved now. The already confusing Affordable Care Act, with its massive regulations, reached a new tipping point as two separate federal appeals courts made contradictory rulings regarding federal subsidies for lower-income enrollees.  One ruled that a strict interpretation of the […]

The Supposed Health Insurer Bailout!

As a professional who spends his entire career on healthcare issues, I get very annoyed when I read articles that put an extremely biased and misleading spin on the emerging healthcare reform activities known as ACA or Obamacare.  Whether one is for or against ACA, it is good to have accurate reporting regarding it to […]

Why Obamacare Is Unraveling

President Obama’s announcement during a Nov. 14 press conference that he would like to see insurance carriers extend non-complying health coverage after Jan. 1 may be the event that unravels the Affordable Care Act (ACA).  Carriers and health plans have worked hard for several years, have spent millions of dollars complying with ACA, have fought […]

Do The Health Exchange Delays Matter?

Almost every morning, we hear about another problem with the Healthcare.gov website.  The Obama administration has committed to fixing the problems by Dec. 1, but the delays will still cause problems that we should be considering. Each carrier or health plan that developed rates for the exchanges developed rates that would apply for 2014.  Although […]

Healthcare Exchanges: Round 2

Most of the dust has now settled around the State Exchanges. Last week the New York rates were finalized and with most of the other states, rates came in lower than anticipated. The Department of Health and Human Services (HHS) released an analysis1 suggesting that rates were 18% lower than anticipated. The national press has […]

Unintended Consequences Of Exchange Rate Filings

For most states offering health care exchanges, rate filings were due by May 1, 2013. Each carrier hoping to operate within the exchange had to finalize their benefit offering and related rate filing. Some of the results are gradually emerging as regulators review the filings. Some have been rejected, some have been accepted and approved, […]

19 Specific Taxes Directly Related To Healthcare Reform

Introduction As we approach April 15 and many of us are thinking about our taxes, we are starting to notice some tax changes and many of these are related to healthcare reform, i.e. the Patient Protection and Affordable Care Act of 2010 (PPACA). Whether or not you are “for” or “against” healthcare reform as currently […]

So What Is the Actuarial Value Of My Health Benefit Plan?

Introduction Now that health care reform is gradually rolling out into the market, the concept of the “actuarial value” of a specific set of benefits is increasingly important. The Patient Protection and Affordable Care Act of 2010 defines four metallic categories of benefit plans ranging from Bronze to Platinum. The actuarial value of these categories […]

Medicare Implements Value-Based Purchasing

aka Medicare Tries Some New Carrots and Sticks! Effective October 1, 2012 Medicare is rolling out its new incentive program for hospitals where 1% of hospital payments are withheld by Medicare in a “pay for performance” or P4P program, with incentives paid out based upon performance against 20 quality metrics. Seventy percent of a hospital’s […]

The Insurance Rate Public Justification & Accountability Act – Does It Get To The Real Problem?

A recent press release states, “The California Secretary of State announced today that a ballot initiative to require health insurance companies to publicly justify and get approval for rate increases before they take effect has qualified for the 2014 ballot.” The release goes on to state, “the initiative would require health insurance companies to refund […]

Affordability, Effectiveness, and Wellness, Part 5

This is Part 5 in a five-part series which presents a creative solution for today’s health care crisis. Additional articles in the series can be found here: Part 1, Part 2, Part 3, and Part 4. An Ideal Health And Wellness Program Based upon our actuarial analysis we find that as much as 75% – […]

Affordability, Effectiveness, and Wellness, Part 4

This is Part 4 in a five-part series which presents a creative solution for today’s health care crisis. Additional articles in the series can be found here: Part 1, Part 2, Part 3, and Part 5. Emergence Of Health And Wellness Programs As A Solution For many years wellness has been viewed from somewhat of […]

Affordability, Effectiveness, and Wellness, Part 3

This is Part 3 in a five-part series which presents a creative solution for today’s health care crisis. Additional articles in the series can be found here: Part 1, Part 2, Part 4, and Part 5. How Much Does Hospital Utilization Vary Anyway? If higher hospital utilization rates are associated with less affordable health care, […]

Affordability, Effectiveness, and Wellness, Part 2

This is Part 2 in a five-part series which presents a creative solution for today’s health care crisis. Additional articles in the series can be found here: Part 1, Part 3, Part 4, and Part 5. Variation in Health Care Affordability To many people's surprise, few studies have reviewed health care affordability. Most analyze cost […]

Affordability, Effectiveness and Wellness, Part 1

This is Part 1 in a five-part series which presents a creative solution for today’s health care crisis. Additional articles in the series can be found here: Part 2, Part 3, Part 4, and Part 5. Improving Affordability Through Health And Wellness And Improved Efficiency: An Overview As we enter a presidential election year, health […]

Surprise, Surprise, Surprise! The Mandate Lives!

Like many others I was glued to the TV set in my hotel room waiting for the news from the US Supreme Court about the Patient Protection and Affordable Care Act Mandate. I had predicted it would be rejected under the Commerce rules (i.e., which did happen), but I was surprised that it was upheld […]

How Will the Supreme Court's Decision Impact Health Care Reform?

Everyone is waiting for the US Supreme Court’s decision on the individual health care mandate anticipated the week of June 25, 2012. The hype is considerable, and the average individual is trying to figure out what this means. Experts disagree what the outcome will be. This articles tries to summarize some of the likely results […]

Has The Projected Cost Of Health Care Reform Changed?

Political pundits continue to argue the advantages and disadvantages of President Obama’s health care reform act (i.e., Patient Protection and Affordable Care Act). Early projections of the potential cost were estimates at best and even the Congressional Budget Office estimates of the cost were seriously questioned by most (i.e., proponents thinking they were too high, […]

Trust-Centric Leadership

It’s hard enough to get the business started on a sound foundation; it’s oftentimes much more challenging to continue operating and transitioning into an adult/mature business. The key to success is establishing and maintaining a “trust-centric leadership” model. Notice that I haven’t used the term manager, or management or manage. Leadership is much different. Leadership […]

Should We Worry About The United States Preventive Services Task Force?

An Insurance Thought Leadership Exclusive In recent weeks much has been said about contraceptive coverage and whether or not President Obama should have done what he did. As a result of that, many are wondering whether or not other decisions will be made by this special government-formed task force that is part of health care […]

Health Plan Mergers – What's Up?

In recent weeks we have seen an uptick in mergers and merger/acquisition rumors. Cigna’s acquisition of HealthSpring, rumors about Aetna and Humana, United’s supposed interest in Coventry and others seem to be fueling these rumors. So why is there so much activity, especially recently? In a typical or normal economy, companies consider acquisition or merger […]

Will the Outlook Get Worse?

Just as most of us thought things were improving and as the Dow was seemingly stabilizing with all of us hoping for a strong recovery, it happened. The elongated and painful negotiations regarding the debt limit, the downgrading of the US credit, and then a tumultuous stock market drop. What’s next? The recent Health Affairs […]

Healthcare Underwriting And Rating Under the Affordable Care Act

The health care reform act, known as the Patient Protection and Affordable Care Act (PPACA), was quickly passed and unfortunately includes many inconsistent and incomplete provisions. Major fix-ups are being incorporated to make it possible to actually enforce (e.g., loss ratio definitions, loss ratio oversight, integration with insurance departments, etc.). Some new provisions are being […]

The Big Mystery – Who’s In and Who’s Out of Obamacare?

There has been continuing discussion about Obamacare and what the reformed system will look like.  The controversial June 2011 McKinsey article suggests that as many as 30% of employers will definitely or probably stop offering employer sponsored insurance after 2014. This somewhat surprising result is much different than initially suggested by the Administration or other […]

California AB52 – Is This A Good Bill Or A Bad Bill?

In the State of California, current law requires carriers and health care service contractors to notify when rate changes are about to happen. In the case of health insurance regulated by the Department of Insurance (i.e., DOI), there is a prohibition of any rate that results in a life-time loss ratio below 70%. New Federal […]

What’s the Scoop On Narrow Networks?

Duke Helfand’s April 3, 2011 article in the LA Times commented on the shift towards smaller networks. This shift is finally getting the eye of the public as health plans use narrower networks as another tool to control health care costs. Is this something worth noting? Does this work? If so, why does it work? […]

So Do We Really Need Health Care Reform?

Health care reform in the form of PPACA was signed into law by President Obama on March 23, 2010. Now more than a year later it is still a significant matter of discussion. The House and the Senate continue to discuss whether or not we need it. Yes this topic has its political sides and […]

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