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Health Watch, June 2017, Issue 83
Health Section Events By Karen Shelton I S S U E 8 3 • J U N E 2 0 1 7 Health Watch 2 | JUNE ... States in 2010 2. $56 billion on sepsis care in U.S. hospitals every day in 2011 3. 30 percent projected ...- Authors: Society of Actuaries
- Date: Jun 2017
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- 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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Medicare Advantage risk scores – Are you competitive?
Medicare ... Non-Duals Duals Av er ag e N um be r o f H CC s Member Category Average Number of HCCs Per Member ... 4 95 –9 9 Av er ag e N um be r o f H CC s Age Group Average Number of HCCs Per Member by Age ...- Authors: Corey Berger
- Date: Oct 2018
- Competency: Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Social Insurance>Medicare
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An Actuarial Model to Improve Health and Reduce Costs
Beckman Chronic disease accounts for 86 percent of U.S. health care costs and an ever-increasing share of ... Diabetes Association, Economic Costs of Diabetes in the U.S. in 2012, http://care.diabetesjournals.org/cont ...- Authors: Ken Beckman
- Date: Oct 2017
- Competency: Leadership>Thought leadership; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy
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Health Watch, Issue 72, May 2013
ticipate in the major changes occurring within the U.S. health care system. I’ll also expand the focus ... we exceed the tar- get. For example, as shown in Table 1, the hospital provider partner can exercise a ...- Authors: Society of Actuaries
- Date: May 2013
- Competency: Results-Oriented Solutions>Actionable recommendations
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
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Improving Medicare Advantage Star Ratings: An Analytical Framework
An Analytical Framework data collection year. Table 1 shows the various elements of the star-ratings ... previous years through the most recent year (Table 2). Table 1 CMS Star-Rating System Timeline Data Collection ...- Authors: Puneet Budhiraja, Rajesh Munjuluri
- Date: Oct 2018
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability; Technology & Applications>Analytics and informatics
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Is Your Integrated Delivery System Throwing Away Free Money?
bid characteristics and plan financials shown in Table 1. We have highlighted the key numbers in dark ... increase by $26.25 PMPM (highlighted in yellow in Table 2). Since CMS funds these claims, the increased ...- Authors: Karan Rustagi
- Date: Feb 2018
- Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional development; Health & Disability>Payment models; Social Insurance>Medicare
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Pricing Issues Resulting from Budget Setting and Stoploss in ACO Arrangements
Pricing Issues Resulting ... In n e R S o f T h e h e A lT h W A T C h A R T IC l e C o n T e S T 30 | ... decrease in quality. The insurer and ACO provider(s) should develop clear definitions of quality and ...- 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
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Abstracts of Health Articles from the North American Actuarial Journal
Abstracts of Health Articles from the North American Actuarial Journal Highlights of health related ... Abstract This research examines the efficiency of U.S. health insurers. It shows that more insurers are ...- Authors: Ian G Duncan
- Date: Jan 2015
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Payment models; Public Policy
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Can Direct-to-Provider Contracting Achieve Value-Based Care for Employer-Sponsored Plans?
Business Group on Health (NBGH), 11 percent of large U.S. employers have adopted direct-to-employer arrangements ... possibility for meaningful transformation within the U.S. health care system to a value-based approach. For ...- Authors: Andrew James Timcheck, Cory Gusland, Michael Gaal
- Date: Dec 2019
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Payment models
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Improving Outcomes Through Incentives: Using a Global Budget with Risk Sharing to Drive Cost Savings and Improved Quality
we exceed the tar- get. For example, as shown in Table 1, the hospital provider partner can exercise a ... their relevance and viability in the market. Table 1 Partner at Risk Service Category target (pmpm) ...- Authors: Edward Cymerys
- Date: May 2013
- Competency: Relationship Management>Relationships and trust; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Management partnership; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Payment models