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What does ERM mean for Health Practitioners?
What does ERM mean for Health Practitioners? In this article, the author discusses ... insurance company, and presents a summary of Aetna's experience with ERM as a case study. Risk-based capital=RBC;Risk ...- Authors: Max Rudolph
- Date: Feb 2010
- Competency: External Forces & Industry Knowledge>External forces and business performance; Relationship Management>Staff management and motivation; Results-Oriented Solutions; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Economics>Health economics; Enterprise Risk Management; Modeling & Statistical Methods>Forecasting
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At the Intersection of Public Health and Actuarial Practice
effective. Despite actuaries’ major role in the U.S. health care system, even a basic overview of the ... significant predictors of health outcomes. More excess mortality in the United States, for instance, is attributable ...- Authors: Barbara Zabielski
- Date: Oct 2017
- Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Public interest representation
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional associations; Health & Disability>Health care; Health & Disability>Payment models; Public Policy; Social Insurance>Medicaid
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Medicare Advantage Part C Revenue: Challenges Ahead
Medicare Advantage Part C Revenue: Challenges Ahead Analysis of the projected impact of the ... based on the Medicare Trustees report and author's assumptions. Patient Protection and Affordable Care ...- Authors: Timothy Courtney
- Date: Jan 2013
- Competency: External Forces & Industry Knowledge>External forces and business performance
- Publication Name: Health Watch
- Topics: Public Policy
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Medicare Advantage Star Ratings: Expectations for New Organizations
Ratings: Expectations for New Organizations By Kelly S. Backes, Julia M. Friedman, Dustin J. Grzeskowiak ... Advantage Bid Rebate Federal Part C Revenue Table 1 2019 Quality Bonus Payment and Rebate Percentages ...- Authors: Kelly Backes, Julia Friedman, Dustin Grzeskowiak, Elizabeth Phillips, Patricia Zenner
- Date: Jun 2018
- Competency: External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>Internal forces and business performance; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Social Insurance>Medicare
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A Conversation with Alan Mills, ND, FSA
had long pondered, namely to build a model of the U.S. health care system. It had become clear to me that ... do it for a health care system, perhaps even the U.S. health care system. Mary: From there, at the University ...- Authors: Mary Moran
- Date: Jan 2014
- 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; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Modeling & Statistical Methods>Simulation
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Navigating New Horizons…Dawn E. Helwig, FSA, MAAA
will they get to 0 before it stops falling?” Mortality, too, is an important rate about which lit- tle ... elderly and/or impaired. But no one has done a mortality table for either active or impaired LTC policyholders—certainly ...- Authors: Mary Kindel Van der Heijde
- Date: May 2009
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>External forces and business performance; Leadership>Thought leadership; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Economics>Health economics; Experience Studies & Data>Long-term care - Experience Studies & Data; Long-term Care>Long-term care insurance; Long-term Care>Public financing - Long-term Care
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New Research Study Measurement of Health Care Quality and Efficiency: Resources for Health Care Professionals
need to address the opportunities to improve the U.S. health care system’s quality and efficiency. ... Actuaries can bring a unique skillset to the table, by leveraging their deep analytic and measurement ...- Authors: Sara Teppema
- Date: Sep 2009
- Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Assess decision effectiveness; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health care quality; Modeling & Statistical Methods>Data mining; Technology & Applications>Analytics and informatics; Technology & Applications>Business intelligence
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Generic Dispensing Rates: Silver Bullet No More?
trend picture even more favorable for generics. Table 1 contains a summary of recent drug trend reports ... in recent years. 12 | MAY 2010 | Health Watch Table 1 Pharmacy Trends Mitigated Through GDR Increases ...- Authors: Troy Filipek
- Date: May 2010
- Competency: External Forces & Industry Knowledge>External forces and business performance; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Economics>Behavioral economics; Economics>Health economics; Social Insurance>Medicare
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Cost and Benefit Trends Observed in July 1, 2011 Renewals for State Employers
following are additional possible explanations. S tate employer health plans face complex cost dynamics ... market in general. The premium trends in the table in Figure A-1 are based on the total premiums as ...- Authors: Robert Gordon Cosway, Barbara Dewey
- Date: Oct 2011
- Competency: External Forces & Industry Knowledge>External forces and business performance
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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Considerations for Surplus Determination under ACA
There are five separate actionable outcomes (see Table 1). For a health care insurer that is between 200 ... He can be reached at richard.tash@optum. com Table 1: Risk-Based Capital authoritative action Outcomes ...- Authors: Daniel Pribe, Richard Tash, David M Tuomala
- Date: May 2014
- Competency: External Forces & Industry Knowledge>External forces and business performance; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Public Policy