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Prologue
Prologue Introduction to the ACA @ 5 publication Patient Protection and Affordable Care Act= PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care ...- Authors: Jim Toole
- 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 Comparison Between the ACA Exchange and Medicare Risk Adjustment Programs
A Comparison Between the ACA Exchange and Medicare Risk Adjustment Programs Risk adjustment is used to adjust the revenue stream to health insurers that sell ACA eligible plans and Medicare ...- Authors: Kurt Wrobel
- Date: Jan 2015
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Social Insurance>Medicare
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The CLASS Act and its Aftermath
The CLASS Act and its Aftermath CLASS Act and ACA Patient Protection and Affordable Care Act= PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care ...- 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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Ehren Nagel: SOA Predictive Analytics Certificate Has Positively Impacted My Work
Ehren Nagel: SOA Predictive Analytics Certificate Has Positively Impacted My Work Early in his career, Ehren Nagel, FSA, MAAA, scoured through podcasts and articles about predictive analytics, ...- Authors: Society of Actuaries
- Date: Nov 2019
- Topics: Health & Disability; Health & Disability>Chronic health management - Health & Disability; 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; Predictive Analytics; Health & Disability>Affordable Care Act (ACA); Health & Disability>Association Health Plans; Health & Disability>Claims - Health & Disability; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques; Predictive Analytics>Programming languages & tools; Health & Disability>Electronic medical record
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Effect of Resource-Based RVS in Medicare on Private Health Insurance
Effect of Resource-Based RVS in Medicare on Private Health Insurance This 1991 open forum discussion is about the resource-based relative value scale [RBRVS] and its impact on physician fee trends ...- Authors: Jay P Boekhoff, Harvey Sobel, Allen Sorbo, Mary P Ratelle
- Date: Jun 1991
- Competency: External Forces & Industry Knowledge
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health insurance; 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
Improving Outcomes Through Incentives: Using a Global Budget with Risk Sharing to Drive Cost Savings and Improved Quality This article describes the results of three years of work by Blue Shield ...- 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
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Taxes and Fees Introduced by the ACA
Taxes and Fees Introduced by the ACA Taxes and Fees Introduced by the ACA Patient Protection and Affordable Care Act= PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss ...- 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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Wall of Comments
Wall of Comments A compilation of feedback from actuaries in the Health Section of the affects of the ACA. Patient Protection and Affordable Care Act= PPACA=Affordable Care Act;Health care ...- Authors: Society of Actuaries
- 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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Session 130: Fraud Detection in Health Care, With and Without Predictive Analytics
Session 130: Fraud Detection in Health Care, With and Without Predictive Analytics The presenters will provide insights into fraud and abuse risk in the health insurance industry, including an ...- Authors: Kwame Smart, Mark Russell, Steve Richardson
- Date: Feb 2020
- Competency: Technical Skills & Analytical Problem Solving
- Topics: Health & Disability; Health & Disability>Health insurance; Health & Disability>Payment models
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Yi-Ling Lin: SOA Predictive Analytics Program Prepares You for Health Care’s Future
Yi-Ling Lin: SOA Predictive Analytics Program Prepares You for Health Care’s Future Yi-Ling Lin, FSA, MAAA, FCA, started the SOA’s Predictive Analytics Certificate Program to keep pace with the ...- Authors: Society of Actuaries
- Date: Nov 2019
- Topics: Health & Disability; Health & Disability>Chronic health management - Health & Disability; 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; Predictive Analytics; Health & Disability>Affordable Care Act (ACA); Health & Disability>Association Health Plans; Health & Disability>Claims - Health & Disability; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques; Predictive Analytics>Programming languages & tools; Health & Disability>Electronic medical record