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Medicare Managed Care Organizations: Getting a Bigger Bang for the Buck
Organizations: Getting a Bigger Bang for the Buck Panel discusses the effects of reduced payment levels to many ... Medicare managed care organizations. From the Record of the Society of Actuaries, Vol. 24, No. 2. Chronic ...- 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
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Profiling Physician Performance
Panelists discuss the methods HMOs employ to measure their providers' quality of care, outcomes, compliance ... guidelines, and cost control. From the Record of the Society of Actuaries, Vol. 25, No. 2. Health care ...- Authors: Joel C Hoffman, David Josephson, David Terry, John C Vataha, Kelly Myers
- Date: Jun 1999
- 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: Actuarial Profession>Ethics; Economics>Health economics; Health & Disability>Health care; Health & Disability>Health care quality; Modeling & Statistical Methods>Regression analysis; Modeling & Statistical Methods>Simulation
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Validating a Novel Health Insurance Fraud Detection Method
detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection ... detection in Medicare. Enterprise Risk Management = ERM;Own Risk Solvency Assessment = ORSA; Health care ...- Authors: Robert D Lieberthal, Elias
- Date: Aug 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; 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: Risk Management
- Topics: Economics>Health economics; Enterprise Risk Management; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Data mining; Predictive Analytics
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Human Nature and the US Health Care System, Part I
and the US Health Care System, Part I The third in a series of four articles that illustrate the “soft” ... “soft” approach of game theory using Thucydides’ master work, The History of the Peloponnesian War. By ...- Authors: Carlos Eduardo Fuentes
- Date: Feb 2018
- Competency: External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>General business skills; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Innovators & Entrepreneurs
- Topics: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health insurance
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Review: “Health Insurance for ‘Humans’: Information Friction
Review: “Health Insurance for ‘Humans’: Information Friction A review of the academic ... Insurance for ‘Humans’: Information Friction A review of the academic article "Health Insurance for ‘Humans’: ...- Authors: Christopher Coulter, Kathleen Dobrzynski, Tyler Engel, Dorothy Andrews
- Date: Nov 2016
- Competency: Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Economics>Behavioral economics; Economics>Health economics; Health & Disability>Health care
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Health Care Financing Systems Around the World
Systems Around the World Presenter describes many of the desirable characteristics of a health care financing ... are found in other parts of the world. The advantages and disadvantages of each alternative system are ...- Authors: Chiu-Cheng Chang
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Global Perspectives; Health & Disability>Health care; Health & Disability>Payment models; Public Policy