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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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Biosimilars, Part 4: The Financial Impact
Part 4: The Financial Impact Savings from biosimilars have accelerated significantly in the past few ... number of relatively recent biosimilar launches that can help to shape our expectations of the financial ...- Authors: Greg Warren, Tony Pistilli
- Date: Nov 2023
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health insurance; Public Policy; Public Policy; Public Policy
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Changing With the Times: The Past and the Future of ACA Risk Adjustment
Changing With the Times: The Past and the Future of ACA Risk Adjustment ACA risk adjustment has now ... years. The original intent of risk adjustment was to help stabilize the market through measuring risk levels ...- Authors: Jason Karcher , Cameron Kevin Gleed, Jason James Petroske
- Date: Jun 2020
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Affordable Care Act (ACA)
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MACRA's Strategic Implications: What Providers and Health Plans Need to Know
Plans Need to Know MACRA not only impact providers, it will impact the entire healthcare market. MACRA ... primarily focused on providers, with the majority of the information addressing the impacts to clinicians ...- Authors: Julie Witt, James Dolstad
- Date: Jul 2019
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Economics; Economics>Health economics; Health & Disability
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How blockchain technology will disrupt the PBM-payer-pharmacy relationship
disrupt the PBM-payer-pharmacy relationship This article explores the disruptive applications of blockchain ... blockchain, an emerging technology, and its impact on the pharmacy benefit space, and pharmacy benefit managers ...- Authors: Brian Anderson, Michael DiPrima , Greg Callahan
- Date: Apr 2020
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Technology & Applications; Technology & Applications>Blockchain & cryptocurrency
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Issue Brief: Changing Financial Risks for Medigap Insurance, Part 2
Part 2 This is Part 2 of 2 on changes affecting Medigap insurers. It focuses on marketing and regulatory ... Medigap and Medicare Advantage that affect the competitiveness of Medigap plans. Medigap, Medicare supplement ...- Date: Mar 2024
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health insurance; Public Policy; Public Policy
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Claims Reserve Margin in the Health Annual Statement: A Review of 2016–2021
Margin in the Health Annual Statement: A Review of 2016–2021 In preparing claims reserves in the annual ... order to satisfy language in both in the National Association of Insurance Commissioners (NAIC) Health ...- Authors: Robert Lang, Elliot McLeRoy
- Date: Nov 2023
- Competency: Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Financial Reporting & Accounting; Financial Reporting & Accounting>Statutory accounting; Health & Disability; Health & Disability>Claims - Health & Disability
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Issue Brief: Changing Financial Risks for Medigap Insurance, Part 1
Insurance, Part 1 During the past few years, performance, cost, and risk trends for Medigap products ... undergone substantial changes. Some of these trends could ease cost pressures on Medigap insurers, while others ...- Authors: Kristi Bohn
- Date: Mar 2024
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health insurance
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February issue of Health Watch
February issue of Health Watch Read the February 2020 issue of Health Watch, published by the Health Section ... Practical information for actuaries, articles impact sections, section activities. 2/24/2020 12:00:00 ...- Authors: Society of Actuaries
- Date: Feb 2020
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability
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June 2019 issue of Health Watch
June 2019 issue of Health Watch Read the June 2019 issue of Health Watch, published by the Health Section ... Practical information for actuaries, articles impact sections, section activities. 7/3/2019 12:00:00 ...- Authors: Society of Actuaries
- Date: Jul 2019
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability