Announcement: SOA congratulates the new ASAs and CERAs for May 2024.

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  • Our Value-Based Cup Runneth Over
    parameters for value-based contracts, come to the table with an open mind and options.  As provider actuaries ... Bring an open mind and options to the negotiating table. Whether quality measurement, risk adjustment models ...

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    • Authors: Daniel Reck (Dan), Lisa Swan, Sam Johnmeyer
    • Date: Aug 2022
    • Competency: Communication; External Forces & Industry Knowledge; Strategic Insight and Integration
    • Publication Name: Health Watch
    • Topics: Enterprise Risk Management>Risk appetite; Enterprise Risk Management>Risk measurement - ERM; Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models; Health & Disability>Provider risk
  • Provider Risk-Sharing and Random Noise
    assume the measurement year costs for a single individual sampled from the population follow a distribution ... While the distribution of costs for a single individual will be skewed, the costs over a provider panel ...

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    • Authors: Thomas Messer
    • Date: Jul 2019
    • Competency: External Forces & Industry Knowledge; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Payment models; Health & Disability>Provider networks; Health & Disability>Provider risk
  • Can Direct-to-Provider Contracting Achieve Value-Based Care for Employer-Sponsored Plans?
    some of which will work better than others for individual providers and employers. It might mean something ... requirements for negotiating 40 or more contracts with individual health systems quickly become onerous for most ...

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    • Authors: Andrew James Timcheck, Cory Gusland, Michael Gaal
    • Date: Dec 2019
    • Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
    • Publication Name: Health Watch
    • Topics: Health & Disability; Health & Disability>Payment models
  • Possible Future of U.S. Healthcare
    industries,13 and sometimes they lose money as in the individual market under ACA. Any insurer, including a nonprofit ... Medicaid 21 percent, and just 6.6 percent have individual insurance.16 Fortunately, these same utilization ...

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    • Authors: Roy Goldman
    • Date: Nov 2019
    • Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
    • Publication Name: Health Watch
    • Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models