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Over the Counter Drugs, theNew Tier Zero in Your PharmacyBenefit Plan
Over the Counter Drugs, theNew Tier Zero in Your PharmacyBenefit Plan With many pharmacy benefit plans now considering whether to add a 4th tier for high priced specialty drugs, review and ...- Authors: Steven D Berna
- Date: Sep 2006
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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Health Care Quality Issues Need Actuarial Input
Health Care Quality Issues Need Actuarial Input This article outlines what the author learned from the Sixth Annual Quality Colloquium at Harvard. From Health Watch, January 2008, Issue No. 57.- Authors: John Cookson
- Date: Jan 2008
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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Letter from the Editor
Letter from the Editor Recap of content contained in the October 2013 issue of the Health Watch newsletter. Health insurance;Medicaid;Health care costs;Patient Protection and Affordable Care Act= ...- Authors: Kurt Wrobel
- Date: Oct 2013
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Professional Values>Practice expertise
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Public Policy
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Working with the CDC on Preventive Care as a Public Health Initiative
Working with the CDC on Preventive Care as a Public Health Initiative Volunteers and staff from the SOA are working with the Centers for Disease Control on public health initiatives to improve ...- Authors: Rebecca Owen
- Date: May 2016
- Competency: Professional Values>Public interest representation
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health risks
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Medicare Advantage: Seven Considerations to Achieve August Resubmission Success
Medicare Advantage: Seven Considerations to Achieve August Resubmission Success Strategies to position Medicare Advantage plans for success during August resubmission. rebate reallocation; ...- Authors: Susan Silseth, Matthew Timm, Kelly Backes, Hillary Millican
- Date: Oct 2017
- Publication Name: Health Watch
- Topics: Actuarial Profession>Best practices; Health & Disability>Health care; Health & Disability>Health insurance; Social Insurance>Medicare
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Medigap: One Part of a Quest for a Fantastic Healthcare Future
Medigap: One Part of a Quest for a Fantastic Healthcare Future Med Supp 5/31/2019 12:00:00 AM ...- Authors: Rajiv Sood
- Date: May 2019
- Competency: External Forces & Industry Knowledge
- Publication Name: News Direct
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks
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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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Seeing The Big Picture: ERM In The Health Care Industry
Seeing The Big Picture: ERM In The Health Care Industry Article discussing the use of enterprise risk management in the health care industry. Enterprise risk management=ERM; Seeing The Big ...- Authors: Robert F Wolf
- Date: Apr 2009
- Competency: External Forces & Industry Knowledge
- Publication Name: The Actuary Magazine
- Topics: Enterprise Risk Management; Health & Disability>Health care
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Restoring the Indifference Ideal: If It’s Not Adjusting for “Risk,” It’s Not “Risk Adjustment”
Restoring the Indifference Ideal: If It’s Not Adjusting for “Risk,” It’s Not “Risk Adjustment” ACA risk adjustment is intended to "bridge the gap" between allowed rates and actuarial rates.- Authors: Greg Fann
- Date: Jun 2022
- Competency: Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Experience Studies & Data; Health & Disability>Health care
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A Mental Health State of the Union
A Mental Health State of the Union This article is intended to inform readers about the current state of mental health and health care in the US, as were it's heading moving forward. Mental ...- Authors: Traci Leigh Hughes
- Date: May 2023
- Competency: Results-Oriented Solutions
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care