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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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Timing’s Everything: The Impact of Benefit Rush
Timing’s Everything: The Impact of Benefit Rush Overview of a benefit rush and its effects on companies. Health ...- Authors: Application Administrator
- Date: May 2008
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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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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Incorporating Random Effects to Reduce Variance in Risk Score Estimation
Effects to Reduce Variance in Risk Score Estimation Traditional risk scoring models include only fixed ... condition-based variables. By including the provider effect as part of the risk scoring model as a random effect ...- Authors: Robert Jason Reed (Jason)
- Date: Jul 2021
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Modeling & Statistical Methods>Estimation methods; Modeling & Statistical Methods>Regression analysis; 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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To Err is Human, To Estimate is Actuarial
Actuarial Realizing the impact of medical errors on the U.S. health care system, the Health Section commissioned ... commissioned a research project to measure the annual frequency of medical errors and their total measurable ...- Authors: Steven Siegel
- Date: Sep 2010
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Actuarial Profession>Academic partnerships; Economics>Health economics; Experience Studies & Data; Modeling & Statistical Methods>Data mining
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Response to March 2021 Practice Note on ASOP 6
March 2021 Practice Note on ASOP 6 Response to March 2021 Practice Note on ASOP 6 blockquote { margin: ... that some aspects of actuarial practice draw more attention from the public and the profession at large ...- Authors: Charles Edwards
- Date: Aug 2022
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Experience Studies & Data>Morbidity; Health & Disability>Health care
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The Retirement Needs Framework: Issues for Health Actuaries
The Retirement Needs Framework: Issues for Health Actuaries Article presents issues for postretirement ... postretirement medical on models, data and the frail elderly. From Health Section News, December 2000, Issue No ...- Authors: Anna M Rappaport
- Date: Dec 2000
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Long-term Care; Modeling & Statistical Methods
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Risk Adjustment: The Details and Why They Matter
Risk Adjustment: The Details and Why They Matter The CMS Risk adjustment model allows actuaries to apply ... knowledge to solve risk and revenue challenges within Health Plans. Health risks;Risk adjustment;Medic ...- Authors: Karena Weikel
- Date: Feb 2018
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks
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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