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  • Medicare Advantage: Five Years after the ACA
    Medicare Advantage: Five Years after the ACA Medicare Advantage and ACA Patient Protection and Affordable ... PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care organizations= ...

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    • Authors: Andrew Mueller, Yingxuan Li
    • 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
  • Medicaid and the ACA
    Medicaid and the ACA Medicaid and the ACA Patient Protection and Affordable Care Act= PPACA=Affordable ... PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care organizations= ...

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    • Authors: Rebecca Owen
    • 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
  • Prologue
    Prologue Introduction to the ACA @ 5 publication Patient Protection and Affordable Care Act= PPACA=Affordable ... PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care organizations= ...

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    • Authors: Jim Toole
    • 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
  • Regulation Of Preferred Provider Organizations 'PPOs' And Other Alternate Delivery Systems
    Regulation Of Preferred Provider Organizations 'PPOs' And Other Alternate Delivery Systems Presented ... discussion is about the status of state and federal regulations regarding the development of PPOs and other ...

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    • Authors: Sandra Drew Anderson, Jay P Boekhoff, James D Clements, Floyd Martin
    • Date: Jun 1986
    • Competency: External Forces & Industry Knowledge>External forces and business performance
    • Publication Name: Record of the Society of Actuaries
    • Topics: Health & Disability>Payment models; Public Policy
  • Health Care Reform: Essential Health Benefits and Actuarial Value
    Health Care Reform: Essential Health Benefits and Actuarial Value Essential Health ... PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care organizations= ...

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    • Authors: Catherine Knuth
    • 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
  • Hospital Entry Into Health Care Financing
    Hospital Entry Into Health Care Financing Presented at October 1986 Annual Meeting. Discussion ... financing from the hospital perspective, the risks and financial incentives from the hospital's perspective ...

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    • Authors: John Fritz, Ronald D Osborne, Virginia S Olds, Clifford Keith Powell
    • Date: Oct 1986
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Strategic Insight and Integration>Strategy development
    • Publication Name: Record of the Society of Actuaries
    • Topics: Health & Disability>Payment models
  • Pricing Issues Resulting from Budget Setting and Stoploss in ACO Arrangements
    ACO budgeting and pricing of stoploss coverage, including: 1) attribution of members; 2) claim carve outs; ... stoploss terms; 4) providers gaming the system and 5) credibility of data. ;; Health care reform; Health ...

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    • Authors: Anthony Rubiano
    • Date: May 2012
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health risks; Health & Disability>Payment models; Public Policy
  • The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries
    The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries Explanation of Medicare ... important features of the program from an actuarial perspective, how the components of the STAR rating are ...

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    • Authors: Adrian L Clark, Gabriela Dieguez, Bradley James Piper
    • Date: May 2012
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy
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