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Measurement of ROI/Effectiveness of Medical Management Processes
narrow identification, which basically says the individual has had an inpatient claim with primary diagnosis ... to-face medical service on the outpatient side (Table 1). The second set of criteria is a broad definition ...- Authors: Ian G Duncan, Robert Parke, Jaan Sidorov
- Date: May 2004
- Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Chronic health management - Health & Disability
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Effective Approaches to Disease Management
treatment certainly. You have to look at the individual characteristics in light of the disease. For ... intervention, but one in which it's hard for the individual to do it; it's a tough lifestyle. It's a lot ...- Authors: Martin F Gibson, Joseph G Korabik, Antony Gallagher Friel, Alan H. Spiro
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Chronic health management - Health & Disability
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Use of Treatment Protocols to Manage Hospital Utilization at the Insurance Payer Level
wanted this thing to go, get everybody around the table to agree on that, and then get everybody to play ... business, some small group business, and some individual health business. It has a broad breadth of products ...- Authors: Donna Kalin, Deborah Loveland, William E Mabe
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care; Health & Disability>Health insurance
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New Strategies in Disease and Utilization Management: Substituting Facts for Assumptions
professional responsible for the care of the individual. Has the activity of the care manager or the ... first is called "Standard Outcome Metrics and a Valuation Methodology for Disease Management Programs." ...- Authors: Ian G Duncan, Alison Johnson, Thomas Wilson
- Date: Jun 2003
- Competency: Strategic Insight and Integration>Strategy development
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Chronic health management - Health & Disability
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Financing Chronic Care Seminar: The Costs of Chronic vs. Acute Conditions
do you predict the incentives of costs for an individual with a chronic disease? What are current obstacles ... reconciliations where vendors have to go to the table with the buyers at the end of the period (hopefully ...- Authors: Ian G Duncan, Charles S Fuhrer, Michael Cousins, Jaan Sidorov, Iver Juster, Nancy A Garrett
- Date: Jun 2005
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Chronic health management - Health & Disability
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An Introduction to Care and Disease Management Interventions, Part 2
that I'd like to see. Then you can summarize individual member data. If you can organize people by class ... Interventions, Part 2 6 As an example, an individual might be in the non-chronic population for a ...- Authors: Ian G Duncan, Henry Dove
- Date: Jun 2005
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Chronic health management - Health & Disability
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High Cost Claimants In Medical Benefit Plans
operationalized as annual adjusted allowable charges for individual claimants. Allowable charges included all expensescovered ... of the information reported so far relates to individual years of data. An important aspect of my research ...- Authors: Kenneth S Avner, John Cookson, Steven Siegel, Leslie M Alexandre, Mary G Henderson
- Date: Oct 1989
- Competency: External Forces & Industry Knowledge
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care
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Financing Chronic Care Seminar: Specific Chronic Condition Studies and Models
how to predict the incentives of costs for an individual with a chronic disease, current obstacles that ... Prior to her academic career, she worked in individual life pricing and product development for Allstate ...- Authors: Stephen P Melek, Marjorie Rosenberg, Robert D Lieberthal, Karen A. Fitzner, Iver Juster
- Date: Jun 2005
- Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Chronic health management - Health & Disability
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Disease Management
gets sick; you treat that individual for the episode, and that individual gets better. That delivery ... an individualized, actionable plan for that individual. You can't just say, "So what if it's high ...- Authors: Dale Rayman, G Todd Swim, Steven Freedman
- Date: Jun 1999
- Competency: External Forces & Industry Knowledge
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Chronic health management - Health & Disability
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Lifestyles and Health Costs
the chart. The interesting thing is not these individual cost drivers themselves. It's the fact they're ... this. What the model looks at is an overweight individual. It assesses that member or that patient with ...- Authors: Daniel Plante, Geoffrey C Sandler, Chris E Stehno, L SS
- Date: Jun 2005
- Competency: External Forces & Industry Knowledge
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Chronic health management - Health & Disability