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Better Care Through Understanding the Customer Not Just the Patient
actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical ... small fraction of their time in these facilities. This article explores what types of data are available ...- Authors: James Dolstad, Craig Cartossa, Justin Hartmann
- Date: Dec 2021
- Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Predictive Analytics; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques
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Give Me Some Credibility: Addressing the Challenge of Volatility in Value-Based Contracts—Part 2
Addressing the Challenge of Volatility in Value-Based Contracts—Part 2 Discover the key components of value-based ... their impact on provider credibility. Learn about benchmarks, measurement period results, and the unique ...- Authors: Maria Knox, James Pisko, Keith Passwater
- Date: May 2023
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Predictive Analytics; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques
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Responsible Machine Learning: Living Up to Our Professional Code of Conduct, ASOPs, and Corporate Requirements
Machine Learning: Living Up to Our Professional Code of Conduct, ASOPs, and Corporate Requirements Actuaries ... Actuarial standards of practice provide guidance around modeling and data. The world has changed significantly ...- Authors: James Dolstad, Abby Steele
- Date: Aug 2022
- Competency: Professional Values; Results-Oriented Solutions; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Predictive Analytics
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Society of Actuaries Analyzes Pharmacy Ecosystem in New Study
Society of Actuaries Analyzes Pharmacy Ecosystem in New Study The Society of Actuaries Research Institute ... a new study to explore pharmacy financing. The goals of the SOA related to this research are to identify ...- Date: Mar 2024
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions
- Topics: Health & Disability; Health & Disability>Health insurance
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A Survey of the Fast-Evolving Landscape for Cell and Gene Therapy Coverage in the United States
A Survey of the Fast-Evolving Landscape for Cell and Gene Therapy Coverage in the United States This ... attempts to make a modest contribution to the dialogue on the potential and risks associated with novel ...- Authors: Ankit Nanda
- Date: May 2024
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health insurance; Reinsurance>Health reinsurance
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Session 077: Medicaid Risk Adjustment: Understanding State Specific Design & Application for Effective Program Management
Session 077: Medicaid Risk Adjustment: Understanding State Specific Design & Application for Effective ... explore the national landscape of state Medicaid risk adjustment program design & application and the key ...- Authors: Zachary Aters, Suzanna-Grace Sayre
- Date: Jul 2019
- Competency: Results-Oriented Solutions
- Topics: Health & Disability>Health insurance; Health & Disability>Payment models
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The Potential of Infra-Low Frequency Neurofeedback to Reduce Medical Claim Costs and Dramatically Improve Patients’ Lives
The Potential of Infra-Low Frequency Neurofeedback to Reduce Medical Claim Costs and Dramatically Improve ... Improve Patients’ Lives The article documents the efficacy of infra-low frequency neurofeedback regarding ...- Date: Jul 2023
- Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health insurance
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Healthcare Risk Adjustment & Predictive Modeling (predicting hospital readmission, draft chapter 20)
Healthcare Risk Adjustment & Predictive Modeling (predicting hospital readmission, draft chapter ... chapter focuses on creating practical models that aid in the prediction of the risk of readmission to ...- Authors: Society of Actuaries
- Date: Jun 2017
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Topics: Health & Disability>Health insurance; Modeling & Statistical Methods>Regression analysis; Technology & Applications>Analytics and informatics
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Opportunities for Bundling Medicare Supplement and Short-Term Care: The Perfect Match?
Bundling Medicare Supplement and Short-Term Care: The Perfect Match? This article describes Medicare Supplement ... in more detail, and we compare their risk profiles. We explore the concept that these two products—when ...- Authors: Kenneth J Clark, Robert T Eaton
- Date: Mar 2021
- Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Rates - Health & Disability; Long-term Care>Long-term care pricing; Long-term Care>Rates - Long-term Care; Long-term Care>Termination - Long-term Care
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A Method for the Calculation of Aggregate Stop-Loss Premiums
A Method for the Calculation of Aggregate Stop-Loss Premiums This paper presents a procedure for calculating ...- Authors: Charles S Fuhrer
- Date: Jan 1988
- Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Actuarial Research Clearing House
- Topics: Health & Disability>Health insurance