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Medicare Managed Care Organizations: Getting a Bigger Bang for the Buck
and home care are scheduled to be in place by 2000. These changes will result in the need for many ... intended to be budget neutral. Also, in the year 2000 there will be risk status adjustment. All of these ...- 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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The CLASS Act and its Aftermath
guid- ance. Nevertheless, the Secre- tary of the U.S. Department of Health and Human Services had sufficient ... future workers. Currently, there are 217 million U.S. adults age 25 and over.9 In order to appreciate ...- Authors: Robert Yee
- 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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Health Care Reform: Essential Health Benefits and Actuarial Value
pre- ACA policies to do so.) In addition, the U.S. Depart- ment of Health and Human Services (HHS) ... required to cover the greater of one drug per U.S. Pharmaceutical (USP) category or class or the same ...- 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
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ACA Impact on Employers - The road ahead and the road behind
size employers constitute 2 per- cent each of all U.S. employers and are subject to phased-in employer ... the United States. Per the report2 issued by the U.S. Census Bureau, over 169 million buy employment-based ...- 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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Epilogue
no magic bullet for curing the problems of the U.S. health care system. However, after years of uncontrolled ... The views expressed herein are those of the author(s) and not necessarily the views of FTI Consulting ...- Authors: Jim Toole, Mary Carmen Easterwood
- Date: Aug 2015
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance
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Surplus and the ACA
construct intended to be an early warn- ing system for U.S. insurance regulators and provide capital adequacy ... Considerations for a Managed Care Orga- nization”, © 2000 Milliman and Robertson, Inc. • NAIC RBC article: ...- 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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Defining Best-In-Market Health Opportunities
Marketing Moderator: DALE H. YAMAMOTO Panelists: MINDY S. KAIREYt Recorder: DALE H. YAMAMOTO Summary: Health ... it all in the past, so, bear with us. Ms. Mindy S. Kairey: We're going to spend a little bit more than ...- Authors: Dale Yamamoto, Mindy S Kairey
- Date: Jun 1998
- 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; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance
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Taxes and Fees Introduced by the ACA
classes of insur- ers. As shown in the illustrative table in Figure 1, the amount by which the insurer would ... cases. The industry made an effort to lobby the U.S. De- partment of Health and Hu- man Services (HHS) ...- Authors: Michael Gaal
- 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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Medicaid and the ACA
Medicaid and the ACA Medicaid and the ACA Patient Protection and Affordable Care Act= PPACA=Affordable ... to interface between the On June 28, 2012, the U.S. Supreme Court issued a deci- sion that while the ...- 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
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A Regulatory Perspective on Rate Review Before and After the Affordable Care Act
released separate guid- ance indicating that the U.S. Department of Health and Hu- man Services (HHS) ... eration of Independent Business v. Sebelius, the U.S. Supreme Court upheld two of the main provisions ...- Authors: Annette James
- 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