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Medicare Advantage risk scores – Are you competitive?
Medicare Advantage risk scores – Are you competitive? What you need to know about risk scores to be competitive ... competitive in the Medicare Advantage market. Medicare;Risk adjustment;Health insurance;Return on investment ...- Authors: Corey Berger
- Date: Oct 2018
- Competency: Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Social Insurance>Medicare
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An Actuarial Model to Improve Health and Reduce Costs
Patient Value model, the PCP receives an incentive payment of $2,000, bringing the total compensation ... compensation to $2,750. The model takes a long-term view recognizing that eliminating a chronic condi- tion will ...- 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
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Health Watch Issue 73, October 2013
Health Watch Issue 73, October 2013 The entire issue of Health Watch. Health care costs;Health care ...- 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
Health Watch, Issue 72, May 2013 May 2013 issue of the Health Watch newsletter Health Care Costs;Health ...- 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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Do Individuals Make Sensible Health Insurance Decisions
Do Individuals Make Sensible Health Insurance Decisions New research shows that we often ... health insurance plan, that lead to unnecessary out-of-pocket expenditu Behavioral economics;E-commerce;Group ...- 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
with Risk Sharing to Drive Cost Savings and Improved Quality This article describes the results of three ... three years of work by Blue Shield of California to collaborate with hospitals and physician organizations ...- 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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Navigating Cost-Sharing Reduction Subsidy Defunding
and Michael Cohen As part of the Affordable Care Act (ACA), carriers in the individual market are required ... silver plan, with the requirement that the carrier must charge the same premium as the standard plan. These ...- 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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Building Actuarial Cost Models From Health Care Claims Data
across the country generates billions of claim records annually. Claim records originate as a form of invoice ... Providers submit the claims to the liable payer (typically a health plan, government agency or the patient) ...- Authors: William Bednar
- Date: Jun 2017
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Influence decisions; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Technology & Applications>Analytics and informatics; Technology & Applications>Business intelligence
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The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries
The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries Explanation of Medicare ... important features of the program from an actuarial perspective, how the components of the STAR rating are ...- 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 79, December 2015, Health Watch
insurance;Ethics;Health reserves;Health Research;Cause-of-death mortality;Disability;Presenteeism;Absenteeism;Smoking ... mortality;health care reform;actuarial standards of practice;Regression analysis;Predictive modeling;Modeling ...- 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