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Medical Loss Ratio: An Entrepreneurial Approach to Health Care Reform
Medical Loss Ratio: An Entrepreneurial Approach to Health Care Reform This is a discussion of the medical loss ratio, the confusion and debate over the calculation method under the new MLR ...- Authors: Mark Florian
- Date: Aug 2011
- Competency: Strategic Insight and Integration
- Publication Name: The Independent Consultant
- Topics: Health & Disability>Health insurance; Public Policy
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Session 059: ACA Risk Adjustment Data Validation – It Matters! Learning from Year 1 and Beyond
Session 059: ACA Risk Adjustment Data Validation – It Matters! Learning from Year 1 and Beyond "The ACA RADV Program will begin to impact issuers’ risk transfers in the 2018 benefit year (BY) ...- Authors: Karena Weikel, Chia Yi Chin, Matthew Sauter, Alexander Mark Vojta
- Date: Jul 2019
- Competency: Strategic Insight and Integration
- Topics: Health & Disability>Health insurance
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The Marketing Front
The Marketing Front 1993 SOA Spring Meeting, Boston. This session is about the marketing front, including demographic trends, impact on products, market research, market segments and ...- Authors: Thomas Marra, H Shumrak, Richard D Jameison
- Date: May 1993
- Competency: Strategic Insight and Integration
- Publication Name: Record of the Society of Actuaries
- Topics: Annuities>Marketing and distribution - Annuities; Health & Disability>Health insurance; Life Insurance>Marketing and distribution - Life Insurance
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Session 125: Pathways to Success: How the MSSP Final Rule has Re-vamped the Program
Session 125: Pathways to Success: How the MSSP Final Rule has Re-vamped the Program On December 21, 2018, the Centers of Medicare & Medicaid Services (CMS) released the final rule for ...- Authors: Noah Champagne, Richard A. Lassow
- Date: May 2019
- Competency: Strategic Insight and Integration
- Topics: Health & Disability>Health insurance; Public Policy
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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 data. That information is captured while patients are in health care facilities. Yet ...- 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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Session 185: The Health Insurance Customer Journey: A Behavioral Finance Perspective
Session 185: The Health Insurance Customer Journey: A Behavioral Finance Perspective Numerous behavioral finance theories have emerged in recent years, many of which apply to insurance. The ...- 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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Possible Future of U.S. Healthcare
Possible Future of U.S. Healthcare What is the difference between a Single-Payer and Universal Health Care System, and how could the U.S. implement a system that would reduce the growth of ...- 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 3.20 stars, compared to existing or established contracts receiving 3.90 ...- 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 045: Operational Risk Management for Health Insurance
Session 045: Operational Risk Management for Health Insurance Enterprise Risk Management is often thought to be synonymous with managing an insurance company toward financial objectives with a ...- Authors: Marc Lambright, Edward M Mailander, Rebecca B Scotchie
- Date: May 2019
- Competency: Strategic Insight and Integration
- Topics: Enterprise Risk Management>Operational risks; Health & Disability>Health insurance