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Projected Cost Analysis of Potential Medicare Pharmacy Plan Designs
Projected Cost Analysis of Potential Medicare Pharmacy Plan Designs Research report sponsored ... cost estimates per member per month, continuance table data, and projected annual costs to the government ...- Authors: Lynette Trygstad, Timothy Feeser, Corey Berger
- Date: Jul 2003
- Competency: External Forces & Industry Knowledge; Leadership>Change management; Professional Values>Public interest representation; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Influence decisions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Topics: Economics>Health economics; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Forecasting; Public Policy; Social Insurance>Medicare; Technology & Applications>Analytics and informatics
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Adjusting for Risk Under Medicare
status indicators, but the health status of an individual has no bearing. Only the health status of perceived ... populations, and then making payments based upon that valuation. This is very simple in concept. For example ...- Authors: Application Administrator, William Lane, Patrick J Dunks, Jill Ann Stockard
- Date: Jun 1999
- Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Social Insurance>Medicare
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Results from the SOA Long-Term Care Think Tank
protection. • Risk was defined as the risk that an individual would require living assis- tance of some sort ... views of improvements to Medicaid. Moreover, any individual is likely to play several roles in the system: ...- Authors: Emily Kessler
- Date: Dec 2005
- Competency: External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>Internal forces and business performance; Leadership>Thought leadership; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Long-Term Care News
- Topics: Long-term Care>Long-term care facilities & home care; Social Insurance>Medicaid; Social Insurance>Medicare
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Medicare Advantage Star Ratings: Expectations for New Organizations
Advantage Bid Rebate Federal Part C Revenue Table 1 2019 Quality Bonus Payment and Rebate Percentages ... star rating are shown in Table 1.4 The current distribution of individual MA contracts by 2018 star ...- Authors: Kelly Backes, Julia Friedman, Dustin Grzeskowiak, Elizabeth Phillips, Patricia Zenner
- Date: Jun 2018
- Competency: External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>Internal forces and business performance; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Social Insurance>Medicare
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Linking Quality and Cost: An Analysis of the Hospital Quality Information Initiative Measures
M.A.A.A. Milliman, Inc. November 29, 2006 TABLE OF CONTENTS Page Executive Summary........... ... data for only one or a few of the indicators. Table 1 shows the percentage of hospitals excluded by ...- Authors: John Cookson, Eileen A Kurtz
- Date: Nov 2006
- Competency: Communication; Strategic Insight and Integration>Influence decisions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Topics: Experience Studies & Data; Health & Disability>Health care quality; Modeling & Statistical Methods>Data mining; Social Insurance>Medicare
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Medicare Modernization Act [MMA] - Changes to Employer Health Plans
complicated when you're a Medicare-eligible individual who doesn't have this kind of coverage and you're ... are just now thinking about it and coming to the table, which doesn't give them a lot of time to make the ...- Authors: Frank R Kopenski, George Wagoner
- Date: Jun 2005
- Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Social Insurance>Medicare
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Risk Adjustment Implementation Issues
Generally, he and I are on opposite sides of the table, but he commands a great deal of respect. He has ... Does it come from a staff model, group model, individual practice association (IPA) or a combination? ...- Authors: John Bertko, Craig Schmid, Mel Ingber
- Date: May 2000
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Public Policy; Social Insurance>Medicare
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Disease Management and the Insurance Industry
Disease Management and the Insurance Industry Does disease management DM positively influence health ... DM have yet to be realized. While many individual studies of disease management purport to show ...- Authors: Jaan Sidorov
- Date: Jun 2005
- Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Topics: Health & Disability>Health care; Social Insurance>Medicare
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Medicare Advantage Hierarchical Condition Categories: Updated Study Results
summary of the variation in HCCs by region. • Individual disease states also vary by age/ gender and geographic ... between employer group and individual mem- bers, we included both individual and employer group members ...- Authors: Corey Berger, Eric P Goetsch
- Date: Jan 2013
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks; Social Insurance>Medicare
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Medicare Managed Care Organizations: Getting a Bigger Bang for the Buck
managed hospital inpatient, $263 out of the $534 (see Table 1). In the well-managed system, that drops to ... the savings are in the hospital inpatient area. TABLE 1 PROJECTED 1999 PMPM BENEFIT COST XYZ COUNTY, ...- Authors: Oscar Lucas, Peggy Tyndall
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health insurance; Social Insurance>Medicare