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Better Care Through Understanding the Customer Not Just the Patient
actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical ... small fraction of their time in these facilities. This article explores what types of data are available ...- 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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Modeling the Unwinding—Where Are We Now?
Modeling the Unwinding—Where Are We Now? Article reviews the data a year into the unwinding of continuous ... continuous coverage provisions in Medicaid, the impact on enrollment counts, how capitation rates have been ...- Authors: Colby Schaeffer
- Date: May 2024
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health risks; Health & Disability>Public financing - Health & Disability
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Session 170: Improve Health Plan Performance by Leveraging CMS and SDOH Data
and growing amount of information that can be leveraged by actuaries. Between the public use and research ... available, large amounts of information that can be assimilated to help understand the who, what, when, where ...- Authors: Paul Erickson, Nina Han, LeeAnna Parrott
- Date: Mar 2020
- Competency: Results-Oriented Solutions
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health risks
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Case Study: Quantifying Healthcare Industry Adverse Disruptors
Your team of actuarial consultants has been engaged by the chief executive officer (CEO) of a successful ... medical care. The corporation’s Board of Directors assigned the CEO to conduct a risk management exercise ...- Authors: Society of Actuaries
- Date: Feb 2016
- Competency: External Forces & Industry Knowledge; Leadership>Mentoring; Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Topics: Actuarial Profession>Competencies; Health & Disability>Health risks
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New and Improved Managed and Unmanaged Care: Reimbursement Models and Disease Management Programs
and Disease Management Programs Panelists discuss the following managed care topics: · Design issues/pros ... · Risk-based capital repercussions · Defined contribution health plans From the Record ...- Authors: Mark Troutman, Brian Dale Shively, Michael Sturm, Kurt Wrobel, Alan Winston, Jane L Johnson
- Date: May 2001
- Competency: Results-Oriented Solutions
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health risks; Reinsurance>Health reinsurance
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Session 012: Large Claims, Large Problems?
a major source of volatility in health care claims experience. In this session, the presenters will ... measuring the associated risk. The presenters will also discuss the early results of the SOA 5/50 research ...- Authors: Joan Barrett, Jacqueline Lee, John Mange, Achilles M Natsis
- Date: May 2019
- Competency: Results-Oriented Solutions
- Topics: Experience Studies & Data>Morbidity; Health & Disability>Health risks