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Trends In Medical Benefit Plan Design To Control Claim Costs
Trends In Medical Benefit Plan Design To Control Claim Costs ... Antiselection;Claims review;Health care costs;Health economics;Individual health plans;Major medical insurance;Deductible;High-deductible ...- Authors: Application Administrator, Peter B Hutzel, Jerry E Lusk, James Miles
- Date: May 1982
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health insurance
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Navigating Cost-Sharing Reduction Subsidy Defunding
Navigating Cost-Sharing Reduction Subsidy Defunding This paper will examine why CSR defunding produces ... Protection and Affordable Care Act, Rate regulation, Individual health plans 3/14/2019 12:00:00 AM ...- Authors: Michael Cohen, Peter van Laarhoven
- Date: Mar 2019
- Competency: Professional Values>Practice expertise; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Public Policy
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Calibrating Risk Score Model with Partial Credibility
regression model was the normalized cost of each individual. The outcomes for very high cost individuals ... regression model. For example, one very high-cost individual flagged for a certain condition could singlehandedly ...- Authors: Sheamus Parkes, Brad Armstrong
- Date: Oct 2015
- Competency: Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Expanding Horizons
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks; Modeling & Statistical Methods>Bayesian methods; Modeling & Statistical Methods>Data mining; Modeling & Statistical Methods>Estimation methods; Predictive Analytics
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Do Individuals Make Sensible Health Insurance Decisions
premium: $930 By selecting Plan A over Plan B, an individual would pay an additional $638 in annual premium ... product actuaries working in both the group and individual markets. EMPIRICAL EVIDENCE OF POOR HEALTH ...- Authors: Alexander Leung, Jonah Yearick, Randy P Herman
- Date: Nov 2016
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development
- Publication Name: Health Watch
- Topics: Economics>Behavioral economics; Economics>Health economics; Health & Disability>Health insurance; Technology & Applications>E-commerce
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Improving Outcomes Through Incentives: Using a Global Budget with Risk Sharing to Drive Cost Savings and Improved Quality
we exceed the tar- get. For example, as shown in Table 1, the hospital provider partner can exercise a ... program produced by the adverse impacts of an individual catastrophic claim on the incentive pool. In ...- Authors: Edward Cymerys
- Date: May 2013
- Competency: Relationship Management>Relationships and trust; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Management partnership; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Payment models
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The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries
payment percentages by star rat- ing are shown in the table in Figure 1. The percentage of the savings a plan ... rebate percentages by star rating are shown in the table in Figure 2. Special rules apply to low-enrollment ...- Authors: Adrian L Clark, Gabriela Dieguez, Bradley James Piper
- Date: May 2012
- Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy
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Health Watch Issue 73, October 2013
program is a temporary feature that will apply to individual and small group qualified health plans (QHPs) ... grandfathered plans, self-funded plans, and non-QHP individual and small group plans will not participate in ...- Authors: Karen Perry, Society of Actuaries
- Date: Oct 2013
- Competency: Results-Oriented Solutions>Actionable recommendations
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
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Health Watch, Issue 72, May 2013
and opinions expressed herein are those of the individual authors and are not necessarily those of the ... we exceed the tar- get. For example, as shown in Table 1, the hospital provider partner can exercise a ...- Authors: Society of Actuaries
- Date: May 2013
- Competency: Results-Oriented Solutions>Actionable recommendations
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
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Health Watch, Issue 79, December 2015, Health Watch
and opinions expressed herein are those of the individual authors and are not necessarily those of the ... are more similar to the individual and worksite products. Worksite and individual products often use simplified ...- Authors: Society of Actuaries
- Date: Dec 2015
- Competency: Communication>Written communication; External Forces & Industry Knowledge; Leadership>Influence; Professional Values>Ethical standards; Relationship Management>Team leadership; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Experience Studies & Data>Disability; Health & Disability>Critical illness insurance; Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks; Modeling & Statistical Methods>Modeling efficiency; Modeling & Statistical Methods>Regression analysis; Technology & Applications>Computer science
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An Actuarial Model to Improve Health and Reduce Costs
health care costs and an ever-increasing share of individual, corporate and government budgets.1 While everyone ... Health Care Data, 2009–2010 Combined Year Tables—Table 1. Annual Number and Percent Distribution of Ambula- ...- Authors: Ken Beckman
- Date: Oct 2017
- Competency: Leadership>Thought leadership; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy