Jake K. Klaisner
FSA, MAAA
Principal and Consulting Actuary
Brookfield, WI, US
Jake Klaisner is a principal and consulting actuary with the Milwaukee office of Milliman. He joined the firm in 2013.
Experience
Jake has over a decade of healthcare experience in managed care pricing, financial reporting, strategic analysis, regulatory analysis, and compliance. His areas of expertise include Medicare Part D, prescription drug analytics, and pharmaceutical manufacturer market access strategy. In the Medicare market, Jake has assisted Medicare Part D plans with bid preparation and strategic analyses. He also conducts firm-wide research in formulary analytics, PDP market dynamics, and Part D risk score analysis. He is a key contributor to Milliman's Part D research efforts. In the pharmacy space, Jake has worked with pharmaceutical manufacturers, industry organizations, and government entities, with emphasis on the Medicare Part D benefit. His recent work includes helping clients with payment strategy, market access, and regulatory issues.
Publications and Presentations
Publications:
- Co-Author, Direct-to-patient Prescription Drugs: A framework to help pharmaceutical manufacturers evaluate their strategy. Milliman White Paper, March 2026.
- Co-Author, Medicare drug price negotiation: New dynamics as the tide turns to Medicare Part B. Maximum Fair Price Issue, January 2026.
- Co-Author, Medicare drug price negotiation: Navigating the next wave of maximum fair prices. Maximum Fair Price Issue, January 2026.
- Co-Author, Variations in Outpatient Hospital Reimbursement for Autoimmune Drugs. An Analysis of Hospital Price Transparency Data. Report, December 2025.
- Co-Author, Continued concentration and sustained stabilization: A 2026 Medicare prescription drug plan market overview. Milliman White Paper, October 2025.
- Co-Author, Analysis of Commercial and Medicare Outpatient Drug Spend at 340B Participating Hospitals. Report, July 2025.
- Co-Author, Medicare Price Negotiation: Year 2 Selection Expands to New Therapeutic Areas. Milliman White Paper, February 2025.
- Co-Author, Demonstrations and consolidations: A first view of the 2025 PDP market. Milliman White Paper, October 2024.
- Co-Author, Medicare price negotiation: Anchored drug prices in uncharted waters. Milliman White Paper, September 2024.
- Co-Author, Impact of anti-obesity medication coverage in the Medicaid and commercial markets. Client Report, June 2024.
- Co-Author, Impact of anti-obesity medication coverage in Medicare Part D. Client Report, June 2024.
- Co-Author, Low income disruption and the $0 premium introduction: 2024 individual Medicare PDP market turbulence. Milliman White Paper, October 2025.
Presentations:
- Charting the IRA’s Drug Price Negotiation: Navigating the Waters of Stakeholder Impacts. SOA webinar, November 2023.
- Anti-Obesity Medication Coverage and Management, Digital Health New York – Obesity Work Group, October 2023.
- Capitalizing on Uncertainty: Winning Strategies with the Inflation Reduction Act. SOA Health Meeting, June 2023.
- Post-IRA Reality and A Way Forward, No Patient Left Behind webinar, September 2022.
- The Inflation Reduction Act: What’s changing in healthcare? Milliman webinar, August 2022.
- Hot Topics Roundtable: Changes in Part D and Part B Drugs – Minimizing Risks and Costs, RISE – Part D Master Class, August 2022.
Professional Designations
- Fellow, Society of Actuaries
- Member, Academy of Actuaries
Education
- BBA, Actuarial Science, Risk Management and Insurance, and Economics, University of Wisconsin
Publications
Read their latest work
Article
Direct-to-patient prescription drugs: A framework to help pharmaceutical manufacturers evaluate their strategy
19 March 2026 - by Michelle (Klein) Robb, Mark F. Gruenhaupt, Jake K. Klaisner
We outline considerations on evaluating medication suitability for manufacturers looking to expand their presence in the direct-to-patient market.
Article
Medicare drug price negotiation: New dynamics as the tide turns to Medicare Part B
18 February 2026 - by Katherine M. Holcomb, Jake K. Klaisner, Dan Simenc
Medicare drug price negotiation: With the first cycle where Part B drugs are eligible to be selected, the implications extend far beyond simple price reductions.
Article
Medicare drug price negotiation: Navigating the next wave of maximum fair prices
12 January 2026 - by Jake K. Klaisner, Katherine M. Holcomb, Dan Simenc
Deeper discounts in the latest round of negotiated prices for Medicare Part D drugs may indicate how future negotiations will play out.
Article
Variations in outpatient hospital reimbursement for autoimmune drugs
17 December 2025 - by Jake K. Klaisner, Kali Schweitzer, Pepper Huang
We analyze hospital price transparency data to show variations in reimbursement for autoimmune drugs, with implications for patient access and affordability.
Article
Continued concentration and sustained stabilization: A 2026 Medicare prescription drug plan market overview
24 October 2025 - by Dylan Collin, Jeremy Hamilton, Jake K. Klaisner
With the 2026 Medicare Advantage and Part D bid cycle affecting costs and revenues, we highlight key changes to the individual prescription drug plan market.
Article
Analysis of commercial and Medicare outpatient drug spend at 340B participating hospitals
30 July 2025 - by Katherine M. Holcomb, Jake K. Klaisner, Philip Nelson, Ivanna Ulin
340B disproportionate share hospitals consistently have higher drug costs across commercial and Medicare plans, according to our latest study on this population.
Article
Medicare price negotiation: Year 2 selection expands to new therapeutic areas
07 February 2025 - by Dan Simenc, Jake K. Klaisner, Katherine M. Holcomb
We provide some insights on Medicare price negotiation's year-two selection, which expands to new therapeutic areas.
Article
Demonstrations and consolidations: A first view of the 2025 PDP market
24 October 2024 - by Jake K. Klaisner, Madeleine Feller
Analyzing data from the Centers for Medicare and Medicaid Services, we highlight key changes in the prescription drug plan market for 2025.
Article
Medicare price negotiation: Anchored drug prices in uncharted waters
05 September 2024 - by Katherine M. Holcomb, Madeleine Feller, Jake K. Klaisner, Jennifer Carioto, Gabriela Dieguez
We explore the implications of the 2026 maximum fair prices within Medicare price negotiation, part of a paradigm shift in Part D access and cost.
Article
Impact of anti-obesity medication coverage in the Medicaid and commercial markets
10 June 2024 - by Jake K. Klaisner, AJ Ally, Briana Botros, Kristin Niakan, Ryan LeRoy
We examine the impact of anti-obesity medication coverage in the Medicaid and commercial markets, as drugs such as Wegovy and Zepbound take off.