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Medicare Managed Care Organizations: Getting a Bigger Bang for the Buck
Medicare Managed Care Organizations: Getting a Bigger Bang for the Buck Panel discusses the effects of reduced payment levels to many Medicare managed care organizations. From the Record of the ...- Authors: Oscar Lucas, Peggy Tyndall
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health insurance; Social Insurance>Medicare
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Dental Diagnosis Coding: The State of the Art
Dental Diagnosis Coding: The State of the Art Diagnostic coding in dental is in its infancy. This article explores the use of medical diagnostic coding and how it may transform dental care in ...- Authors: Joanne E Fontana
- Date: Jun 2017
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance
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An Executive Roundtable on the State of Predictive Analytics in U.S. Health Care
An Executive Roundtable on the State of Predictive Analytics in U.S. Health Care Many executives are talking about predictive analytics uses in health insurance. Analytics and informatics ...- Authors: Marilyn Medved McGaffin
- Date: Mar 2017
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Technology & Applications>Analytics and informatics
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Is there currently an underwriting cycle?
Is there currently an underwriting cycle? An analysis of the 1999-2011 experience of all Blues plans of betweeen $1.8 and $3.8 billion in annual revenue in 2010 to determine if there is any ...- Authors: Mark Shaw
- Date: Jan 2013
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Enterprise Risk Management>Capital management - ERM; Enterprise Risk Management>Systematic risk; Health & Disability>Health insurance
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Surplus and the ACA
Surplus and the ACA Surplus and the ACA Patient Protection and Affordable Care Act= PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care ...- Authors: Daniel Pribe
- Date: Aug 2015
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
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The Role of the Affordable Care Act in Payment Reform
The Role of the Affordable Care Act in Payment Reform Affordable Care Act and Payment Reform Patient Protection and Affordable Care Act= PPACA=Affordable Care Act;Health care reform;Health ...- Authors: Juliet Michelle Spector
- Date: Aug 2015
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
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ACA Impact on Employers - The road ahead and the road behind
ACA Impact on Employers - The road ahead and the road behind ACA Impact on Employers Patient Protection and Affordable Care Act= PPACA=Affordable Care Act;Health care reform;Health insurance; ...- Authors: Sujaritha Tansen, Brian Stentz
- Date: Aug 2015
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
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Dental Coverage and the ACA
Dental Coverage and the ACA This article discusses the challenges and unknowns relating to the regulatory inclusion of pediatric dental benefits within the essential benefits list of the ...- Authors: Laurence R Weissbrot
- Date: May 2012
- 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 insurance; Public Policy
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Risk Theory Applications To Experience Rating Group Health Insurance
Risk Theory Applications To Experience Rating Group Health Insurance Presenter offers ways in which actuaries might set credibility levels to be used by underwriters to set group health insurance ...- Authors: Charles S Fuhrer
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Influence decisions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Actuarial Profession; Health & Disability>Health insurance; Modeling & Statistical Methods>Estimation methods
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Risk-Based Capital for Health Organizations
Risk-Based Capital for Health Organizations Panelists report on the status of activities by national associations in regard to risk-based capital requirements for health insurers. From the ...- Authors: Julia T Philips, Donna C Novak, Steven Wander
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Big picture view
- Publication Name: Record of the Society of Actuaries
- Topics: Enterprise Risk Management>Risk measurement - ERM; Health & Disability>Health insurance; Health & Disability>Health risks