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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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Give Me Some Credibility: Addressing the Challenge of Volatility in Value-Based Contracts—Part 2
Addressing the Challenge of Volatility in Value-Based Contracts—Part 2 Discover the key components of value-based ... their impact on provider credibility. Learn about benchmarks, measurement period results, and the unique ...- Authors: Maria Knox, James Pisko, Keith Passwater
- Date: May 2023
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; 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; Predictive Analytics; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques
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Calculation of Confidence Intervals for IBNR Estimates Using the Average PMPM Method
Calculation of Confidence Intervals for IBNR Estimates Using the Average PMPM Method Presents a step-by-step ... estimates derived using the Averaqe PMPM method. It is a companion article to the January 2023 Health Watch ...- Authors: Robert Lynch
- Date: May 2024
- Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Financial Reporting & Accounting; Health & Disability
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When Affordability Savings Do Not Reduce Costs
Affordability Savings Do Not Reduce Costs Regression to the mean is a phenomenon that arises when comparing sequential ... closer to the average. Health care actuaries need to understand and be able to mitigate the effects of regression ...- Authors: Tony Pistilli
- Date: Dec 2020
- Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Modeling & Statistical Methods>Forecasting; Modeling & Statistical Methods>Regression analysis; Predictive Analytics>Modeling techniques; Predictive Analytics>Quality control & model governance
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The Potential of Infra-Low Frequency Neurofeedback to Reduce Medical Claim Costs and Dramatically Improve Patients’ Lives
The Potential of Infra-Low Frequency Neurofeedback to Reduce Medical Claim Costs and Dramatically Improve ... Improve Patients’ Lives The article documents the efficacy of infra-low frequency neurofeedback regarding ...- Date: Jul 2023
- Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health insurance
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The Application of Data Blending to Resolve Unrelated Dimensions: A Tableau Use-Case for Calculating Per Member Per Year
The Application of Data Blending to Resolve Unrelated Dimensions: A Tableau Use-Case for Calculating ... tables through the ETL process. However, when calculating PMPY at specific levels of detail using these ...- Date: May 2023
- Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Experience Studies & Data; Technology & Applications; Technology & Applications>Business intelligence; Technology & Applications>Computer science; Experience Studies & Data>Rate calculations; Experience Studies & Data>Table construction; Technology & Applications>Visualization
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Opportunities for Bundling Medicare Supplement and Short-Term Care: The Perfect Match?
Bundling Medicare Supplement and Short-Term Care: The Perfect Match? This article describes Medicare Supplement ... in more detail, and we compare their risk profiles. We explore the concept that these two products—when ...- Authors: Kenneth J Clark, Robert T Eaton
- Date: Mar 2021
- Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Rates - Health & Disability; Long-term Care>Long-term care pricing; Long-term Care>Rates - Long-term Care; Long-term Care>Termination - Long-term Care
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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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Digital Health
Digital Health This article is ... a brief overview of what digital health is, how it is regulated, and who some of the big unicorns are ...- Authors: Marilyn Medved McGaffin
- Date: Feb 2020
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Technology & Applications; Technology & Applications>Analytics and informatics; Technology & Applications>Cyber risk; Technology & Applications>Telematics; Technology & Applications>Wearables & implants
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Underwriting Gain in Managed Medicaid: Starting the Conversation
Starting the Conversation According to the Actuarial Standards Board’s Actuarial Standard of Practice ... underwriting gain in order to provide compensation for the risks assumed by an MCO. However, there is no generally ...- Authors: Jaredd Martin Keith Simons, James Randolph Piekut
- Date: Nov 2019
- Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Modeling & Statistical Methods; Modeling & Statistical Methods>Forecasting; Modeling & Statistical Methods>Scenario generation; Modeling & Statistical Methods>Simulation