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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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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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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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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