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Review: “Health Insurance for ‘Humans’: Information Friction
HEALTH INSURANCE Currently, more than 80 percent 1 of large U.S. employers offer their employees, either as one ... switch for each of the four models presented in Table 6. The results for both the types model and the ...- Authors: Christopher Coulter, Kathleen Dobrzynski, Tyler Engel, Dorothy Andrews
- Date: Nov 2016
- Competency: Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Economics>Behavioral economics; Economics>Health economics; 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
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Reserving Challenges for Consumer-Directed Health Products
involved, followed by a corridor of the consumer ’s responsibility for payment until the deductible is ... sign up today at: w w w. s o a . o r g / c c m / c m s - s e r v i c e / s t r e a m / asset/?asset_id=5179052&g11n ...- Authors: Stephen J Kaczmarek
- Date: Oct 2004
- Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance
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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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Rethinking Family Tiers
Rethinking Family Tiers A closer look at family tier factor rating assumptions, and how well ... average adult costs would suggest. The follow- ing table shows the claims ratios we experienced, where we ...- Authors: Kristi Bohn
- Date: Jan 2011
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Modeling & Statistical Methods>Data mining; Technology & Applications>Analytics and informatics
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ERM Opportunities for Health Practitioners
ERM Opportunities for Health Practitioners Summary of recent SOA-sponsored research on Enterprise ... appropriate for them to take a seat at the ERM table and be considered to head this team. As with any ...- Authors: Max Rudolph
- Date: May 2010
- Competency: Communication; External Forces & Industry Knowledge>External forces and business performance; Leadership>Change management; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Actuarial Profession>Alternative careers; Actuarial Profession>Best practices; Enterprise Risk Management; Enterprise Risk Management>Compliance
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The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries
payment percentages by star rat- ing are shown in the table in Figure 1. The percentage of the savings a plan ... rebate percentages by star rating are shown in the table in Figure 2. Special rules apply to low-enrollment ...- Authors: Adrian L Clark, Gabriela Dieguez, Bradley James Piper
- Date: May 2012
- Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy
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Medicare Advantage Hierarchical Condition Categories: Updated Study Results
Medicare Advantage Hierarchical Condition Categories: Updated Study Results Summary and analysis of the ... ESRd members. (2) Regions are based on the U.S. census definitions. a diabetes HCC who do not ...- Authors: Corey Berger, Eric P Goetsch
- Date: Jan 2013
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks; Social Insurance>Medicare