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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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Transparency Leads Actuarial Survey of Trend-Benders
Actuarial Survey of Trend-Benders Summary of results of a 2010 Health Section survey of actuaries and Medicare ... Medicare population, on ways to bend the cost trend curve downward. Issues included transparency, quality ...- Authors: Sara Teppema
- Date: Sep 2010
- Competency: Communication; Leadership>Professional network leverage; Leadership>Thought leadership; Strategic Insight and Integration>Strategy development
- Publication Name: Health Watch
- Topics: Health & Disability>Health care quality; Public Policy; Public Policy
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Commercial Health Care: What’s Next?
Commercial Health Care: What’s Next? This article ... contains excerpts from the first three articles that were released through the strategic initiative - ...- Date: Oct 2017
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Influence decisions; Strategic Insight and Integration>Strategy development; 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; Public Policy; Public Policy
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Section 1332 Waivers: Coming Soon to a State Near You?
requirements of the Patient Protection and Affordable Care Act. The article focuses on specific opportunities ... opportunities for states and the role that actuaries will play. Patient Protection and Affordable Care Act= ...- Authors: Gregory Fann
- Date: May 2016
- Competency: Strategic Insight and Integration>Strategy development
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability; Public Policy; Public Policy
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Provider Payment Reform: An Accountable Care Approach to Alignment of Health Care Goals and Incentives
Reform: An Accountable Care Approach to Alignment of Health Care Goals and Incentives A proposal to address ... accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by ...- Authors: Mark Florian
- Date: Sep 2010
- Competency: Leadership>Thought leadership; Professional Values>Public interest representation; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health care quality; Health & Disability>Payment models; Public Policy; Reinsurance>Stop-loss insurance
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Similarities between Medicare Prescription Drug Plans and Commercial Exchanges
Exchanges This article compares the Prescription Drug Plan (PDP) market to the commercial individual market ... in the Affordable Care Act. PDP carrier actions to date could help predict certain aspects of the exchange ...- Authors: Shelly Brandel
- Date: Jan 2013
- Competency: Strategic Insight and Integration>Strategy development
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Public Policy; Public Policy; Social Insurance>Medicare
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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 Enables Wealth
Mental health spending has reached $147 billion in the United States with demand only increasing greatly ... crisis surpassing 1 percent of the GDP. These costs coupled with the severe lack of licensed clinicians calls ...- Authors: Rich Gengler, Irving Steel, Stevan Hobfoll
- Date: May 2016
- Competency: Leadership>Thought leadership; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health information technology; Health & Disability>Health insurance; Public Policy; Public Policy
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Value Based and Accountable Care: The Actuarial and Clinical Role in Building a Sustainable Model
Value Based and Accountable Care: The Actuarial and Clinical Role in Building a Sustainable Model As ... model into the future. This requires actuarial and clinical/provider capabilities to assess the care management ...- Authors: Mark Bethke, James M Whisler, Amanda Holland
- Date: May 2013
- Competency: Leadership>Change management; Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Payment models; Modeling & Statistical Methods>Forecasting; Modeling & Statistical Methods>Sensitivity testing; Modeling & Statistical Methods>Value at risk - Modeling & Statistical Methods; Public Policy
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An Interview: Shannon Brownlee
Brownlee Shannon Brownlee shares her perspectives on the current health care crisis, including: inconsistent ... guidelines, the need for better independent clinical research to establish those guidelines, and the limits ...- Authors: Mary Kindel Van der Heijde, Douglas Norris
- Date: Sep 2009
- Competency: Professional Values>Public interest representation; Results-Oriented Solutions>Assess decision effectiveness; Strategic Insight and Integration>Strategy development
- Publication Name: Health Watch
- Topics: Health & Disability>Health care quality; Public Policy; Public Policy