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Restoring the Indifference Ideal: If It’s Not Adjusting for “Risk,” It’s Not “Risk Adjustment”
Restoring the Indifference Ideal: If It’s Not Adjusting for “Risk,” It’s Not “Risk Adjustment” ACA risk adjustment ... intended to "bridge the gap" between allowed rates and actuarial rates. If risk adjustment methodology ...- Authors: Greg Fann
- Date: Jun 2022
- Competency: Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Experience Studies & Data; Health & Disability>Health care
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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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Understanding the Medical Stop-Loss Market
Understanding the Medical Stop-Loss Market This article details the medical stop-loss coverages purchased ... providers taking delegated financial risk in payor agreements. Along the way we will identify strategies purchasers ...- Authors: Keith Passwater, Peter Robinson, David Nelson
- Date: Jun 2022
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Reinsurance; Health & Disability>Provider risk
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Our Value-Based Cup Runneth Over
Our Value-Based Cup Runneth Over Discussion of how to mature value-based contracts between health insurers ... parameter consistency, revenue predictability and risk assessment. Intended audience are health plan and ...- Authors: Daniel Reck (Dan), Lisa Swan, Sam Johnmeyer
- Date: Aug 2022
- Competency: Communication; External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Enterprise Risk Management>Risk appetite; Enterprise Risk Management>Risk measurement - ERM; Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models; Health & Disability>Provider risk
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Responsible Machine Learning: Living Up to Our Professional Code of Conduct, ASOPs, and Corporate Requirements
Machine Learning: Living Up to Our Professional Code of Conduct, ASOPs, and Corporate Requirements Actuaries ... Actuarial standards of practice provide guidance around modeling and data. The world has changed significantly ...- Authors: James Dolstad, Abby Steele
- Date: Aug 2022
- Competency: Professional Values; Results-Oriented Solutions; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Predictive Analytics