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Better Care Through Understanding the Customer Not Just the Patient
As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical ... information is captured while patients are in health care facilities. Yet most people spend only a small fraction ...- 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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Possible Future of U.S. Healthcare
difference between a Single-Payer and Universal Health Care System, and how could the U.S. implement a system ... quality. Medicare for All, Payment reforms=Health care payment reforms 11/22/2019 12:00:00 AM ...- Authors: Roy Goldman
- Date: Nov 2019
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
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New Contract Medicare Star Ratings: Why The Sudden Cliff?
New Contract Medicare Star Ratings: Why The Sudden Cliff? On average, contracts receiving their first star rating receive ... Rating cliff? Value-based insurance design, Managed care 1/6/2020 12:00:00 AM ...- Authors: Suzanna-Grace Sayre, Danielle Beierle
- Date: Jan 2020
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance
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Session 185: The Health Insurance Customer Journey: A Behavioral Finance Perspective
closely follow federal law. The Sherman Act, is the primary U.S. antitrust law pertaining to association activities ... enrollment Member Acquisition • Health and wellness • Care management • Social Determinants of Health Member ...- Authors: Lijia Guo, Randall Herman, Joseph Slater
- Date: Mar 2020
- Competency: Strategic Insight and Integration
- Topics: Economics; Economics>Behavioral economics; Health & Disability; Health & Disability>Health insurance
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Issue Brief: Changing Financial Risks for Medigap Insurance, Part 2
(snowbirds, for example); and cover their major health care needs without MA’s utilization reviews and the risk ... as well as likely delays in receiving necessary care.[4] Providers may also appreciate Medigap-covered ...- Date: Mar 2024
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health insurance; Public Policy; Public Policy
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Issue Brief: Changing Financial Risks for Medigap Insurance, Part 1
patients who deferred certain types of care or simply sought less care than they normally would (or should) ... financial improvements due to delayed and averted care in 2020 and 2021 than did other types of health ...- Authors: Kristi Bohn
- Date: Mar 2024
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health insurance
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Biosimilars, Part 3: Humira Biosimilar Launches
patients everywhere. prescription drug costs, health care payment reforms, medical expenses By Gregory Warren ... inclusion in formularies so patients can have the care access they need. To remove Humira from your formulary ...- Authors: Tony Pistilli, Greg Warren
- Date: Nov 2023
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health insurance; Public Policy; Public Policy; Public Policy
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Biosimilars, Part 4: The Financial Impact
Biosimilars, Part 4: The Financial Impact Savings from biosimilars have accelerated significantly ... year’s big event. prescription drug costs, health care payment reforms, medical expenses By Gregory Warren ...- Authors: Greg Warren, Tony Pistilli
- Date: Nov 2023
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health insurance; Public Policy; Public Policy; Public Policy