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Behavioral Economics: Overview and Healthcare Applications
assumes an individual “thinks and chooses unfailingly well,”2 whereas the latter assumes an individual is “not ... but behavioral economics took advantage of individual human behavior to the benefit of the airport ...- Authors: Randy P Herman, Tony Pistilli, Brian Plaskow, Jeffrey Chanin
- Date: Aug 2020
- Competency: External Forces & Industry Knowledge; Relationship Management; Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Economics; Economics>Behavioral economics; Economics>Health economics; Health & Disability; Health & Disability>Health care
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Restoring the Indifference Ideal: If It’s Not Adjusting for “Risk,” It’s Not “Risk Adjustment”
liability associated with each enrollee. A change in individual market regulatory dynamics occurred in October ... shouldn’t be looking at the risk level of that individual consumer signing up for coverage. You should ...- Authors: Greg Fann
- Date: Jun 2022
- Competency: Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Experience Studies & Data; Health & Disability>Health care
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New Contract Medicare Star Ratings: Why The Sudden Cliff?
enrollment required for a contract to receive an individual measure Star Rating depends on the specific ... between 500 and 1,000 members will receive enough individual measure Star Ratings to earn an overall Star ...- Authors: Suzanna-Grace Sayre, Danielle Beierle
- Date: Jan 2020
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance
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Better Care Through Understanding the Customer Not Just the Patient
data points are closest to other “like” members. Table 1 is an example of the resulting grouping for six ... representing the lowest and dark green the highest. Table 1 Member Retention Cluster Analysis * Normalized ...- 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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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 ...- 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
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Biosimilars, Part 4: The Financial Impact
Biosimilars, Part 4: The Financial Impact Savings from biosimilars have accelerated significantly ... and opinions expressed herein are those of the individual authors and are not necessarily those of the ...- Authors: Greg Warren, Tony Pistilli
- Date: Nov 2023
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health insurance; Public Policy; Public Policy; Public Policy
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Medicaid and the ACA - Coverage of Medicaid home and community-based services under the 1915(i) state plan option
1915(c) of the SSA, which re- quires that an individual satisfy state-established institutional level ... waivers and the 1915(i) state plan option. The table in Figure 1 (pg. 21) provides a com- parison of ...- Authors: Marlene Howard, Robert Damler
- Date: Jul 2015
- Competency: External Forces & Industry Knowledge; Professional Values; Strategic Insight and Integration
- Publication Name: In The Public Interest
- Topics: Health & Disability>Health care; Long-term Care>Public financing - Long-term Care; Social Insurance>Medicaid
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Biosimilars, Part 3: Humira Biosimilar Launches
Biosimilars, Part 3: Humira Biosimilar Launches The big event of 2023 is the launch of multiple ... and opinions expressed herein are those of the individual authors and are not necessarily those of the ...- Authors: Tony Pistilli, Greg Warren
- Date: Nov 2023
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health insurance; Public Policy; Public Policy; Public Policy
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Managed Care 3.0 Technology
Managed Care 3.0 Technology Actuaries are currently familiar with the impact of new technologies ... and opinions expressed herein are those of the individual authors and are not necessarily those of the ...- Authors: Joan Barrett, Sudha Shenoy
- Date: Jan 2021
- Competency: Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Technology & Applications
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Accountable Care Organizations: An Untapped Opportunity
third-party, objective analysis when they are at the table bargain- 8 | september 2010 | Health Watch area ... health care costs if actuaries had been at the table with providers earlier in the process. ACO leadership ...- Authors: Jim Toole, Sara Teppema
- Date: Sep 2010
- Competency: External Forces & Industry Knowledge>External forces and business performance; Leadership>Thought leadership; Professional Values>Public interest representation; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Enterprise Risk Management>Risk measurement - ERM; Enterprise Risk Management>Strategic risks; Health & Disability>Health care; Public Policy