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What the Repeal and Replacement of the Affordable Care Act Will Look Like
What the Repeal and Replacement of the Affordable Care Act Will Look Like Republicans have promised to repeal and replace the Affordable Care Act for years. Now that they have power, what will ...- Authors: Joseph Slater, Joshua Strupcewski, John Culkin
- Date: Mar 2017
- Competency: Professional Values>Public interest representation
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Public Policy; Social Insurance>Government-funded healthcare; Social Insurance>Medicaid; Social Insurance>Medicare
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Provider-Sponsored Organizations PSOs
Provider-Sponsored Organizations PSOs Conditions and required solvency standards of federal waiver to PSOs to provide Medicare+Choice products. Effect on providers, beneficiaries and employers.- Authors: John Kinney
- Date: Dec 1998
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Public Policy; Social Insurance>Medicare
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Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews
Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the ...- Authors: Corey Berger, Eric P Goetsch
- Date: Jan 2011
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Demography; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining; Social Insurance>Medicare; Technology & Applications>Analytics and informatics
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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 in the Medicare Advantage market. Medicare;Risk adjustment;Health insurance;Return ...- 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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Medicare Advantage—Future Benchmarks
Medicare Advantage—Future Benchmarks This article discusses future benchmarks of Medicare and Medicare's rising costs and its relativity to the actuarial profession. Managed care;Payment ...- Authors: Application Administrator
- Date: May 2008
- Competency: External Forces & Industry Knowledge>External forces and business performance
- Publication Name: Health Watch
- Topics: Public Policy; Social Insurance>Medicare
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Soundbites from the American Academy of Actuaries’ Health Practice Council
Soundbites from the American Academy of Actuaries’ Health Practice Council Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate health care ...- Authors: Heather E Jerbi, Melissa Stevens
- Date: Sep 2009
- Competency: Communication>Written communication; Leadership>Influence; Professional Values>Public interest representation; Strategic Insight and Integration>Influence decisions
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional associations; Health & Disability>Health risks; Public Policy; Public Policy; Social Insurance>Medicare
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Medicare Advantage Hierarchical Condition Categories: Updated Study Results
Medicare Advantage Hierarchical Condition Categories: Updated Study Results Summary and analysis of the diseases and conditions exhibited in the Medicare Advantage population Medicare;Risk ...- Authors: Corey Berger, Eric P Goetsch
- Date: Jan 2013
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks; Social Insurance>Medicare
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Escaping the Addiction – From Preferred Payer to Rational Pricing
Escaping the Addiction – From Preferred Payer to Rational Pricing A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay ...- Authors: Hobson Carroll
- Date: Sep 2010
- Competency: Leadership>Thought leadership; Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability; Public Policy; Public Policy; Social Insurance>Medicaid; Social Insurance>Medicare
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Prevalence of Supplemental Benefits in the Medicare Advantage Marketplace: 2017 to 2021
Prevalence of Supplemental Benefits in the Medicare Advantage Marketplace: 2017 to 2021 This article focuses on mandatory supplemental benefits offered by general enrollment plans and Dual ...- Authors: Julia Friedman
- Date: Mar 2021
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Social Insurance>Medicare
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HCFA & Medicare + Choice: Contract Year 2001 Changes
HCFA & Medicare + Choice: Contract Year 2001 Changes Outline of changes to the Adjust Community Rate ACR Proposal process and Beneficary Information Form, Issue No. 38 Managed ...- Authors: Anant Galande
- Date: Aug 2000
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Social Insurance>Medicare