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Considerations for Surplus Determination under ACA
Considerations for Surplus Determination under ACA Discussion of the impact of the ... ACA Discussion of the impact of the ACA on RBS and required surplus for a health plan Risk-based capital=RBC;Patient ...- Authors: Daniel Pribe, Richard Tash, David M Tuomala
- Date: May 2014
- Competency: External Forces & Industry Knowledge>External forces and business performance; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Public Policy
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Medicare Advantage Part C Revenue: Challenges Ahead
Challenges Ahead Analysis of the projected impact of the Affordable Care Act on Medicare Part C revenue ... with background on recent historical revenue trends. The analysis is largely based on CMS published data ...- Authors: Timothy Courtney
- Date: Jan 2013
- Competency: External Forces & Industry Knowledge>External forces and business performance
- Publication Name: Health Watch
- Topics: Public Policy
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The Evolution of the Individual Market (Part II)
The Evolution of the Individual Market (Part II) Part II of a two-part series discussing individual ... individual market evolution from before the ACA through President Trump's first term. Individual health plans ...- Authors: Gregory Fann
- Date: Mar 2019
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Public Policy; Public Policy
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Commercial Health Care: What’s Next?
condensed summary and excerpt from the fourth white paper in the Commercial Health Care: What’s Next ... Next? series. health care reform;risk adjustment;health insurance;health policy;health risks 6442480945 ...- Authors: David Dillon
- Date: Feb 2018
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; Leadership>Thought leadership
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health risks; Public Policy; Public Policy
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Accountable Care Organizations: An Untapped Opportunity
provider risk under various ACO models, limitations of the Medicare model for motivating change in the health ... strategic priorities, attribution of members, meaurement, and the roles actuaries can play. Accountable ...- 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
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Commercial Healthcare: What's Next
Commercial Healthcare: What's Next A new initiative, Commercial Health Care: What’s ... will focus on education and research for health actuaries regarding issues that remain with the ACA. health ...- Authors: David Dillon, Elaine Corrough
- Date: Jun 2017
- Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Practice expertise; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Public Policy; Public Policy
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Commercial Health Care: What’s Next? A Health Section Strategic Initiative
What’s Next? A Health Section Strategic Initiative The Health Section's strategic initiative entitled ... entitled Commercial Health Care: What’s Next? focuses on health care reform. This article contains a summary ...- Authors: David Dillon
- Date: Oct 2018
- Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Public Policy; Public Policy
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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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Behind Clinical Integration
activity has highlighted the importance of Clinical Integration in improving the quality, safety, efficiency ... infrastructure of the health care system. This article discusses relevance and implication of regulatory ...- Authors: Steven Tutewohl
- Date: May 2010
- Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Public interest representation; Strategic Insight and Integration>Effective decision-making
- Publication Name: Health Watch
- Topics: Health & Disability>Health information technology; Public Policy; Technology & Applications>Data warehousing; Health & Disability>Electronic medical record
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Medicare Advantage—Future Benchmarks
Medicare Advantage—Future Benchmarks This article discusses future benchmarks of Medicare ... future benchmarks of Medicare and Medicare's rising costs and its relativity to the actuarial profession ...- Authors: Application Administrator
- Date: May 2008
- Competency: External Forces & Industry Knowledge>External forces and business performance
- Publication Name: Health Watch
- Topics: Public Policy; Social Insurance>Medicare