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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 ...

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    • 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
  • Health Care Funding Report
    Health Care Funding Report The International Actuarial Association Health Section, the Society of Actuaries International Section, and American Academy of Actuaries (AAA) published the report “ ...

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    • Authors: Susan Lynn Mateja, Shereen Sayre
    • Date: Jan 2021
    • Competency: External Forces & Industry Knowledge
    • Publication Name: International News
    • Topics: Health & Disability>Health care; Health & Disability>Payment models; Social Insurance>Government-funded healthcare
  • At the Intersection of Public Health and Actuarial Practice
    At the Intersection of Public Health and Actuarial Practice An edited written interview with two actuaries and a public health professional on issues related to the intersection between the two ...

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    • Authors: Barbara Zabielski
    • Date: Oct 2017
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Public interest representation
    • Publication Name: Health Watch
    • Topics: Actuarial Profession>Professional associations; Health & Disability>Health care; Health & Disability>Payment models; Public Policy; Social Insurance>Medicaid
  • Provider Risk-Sharing and Random Noise
    Provider Risk-Sharing and Random Noise Discussion and Opinion on how randomness affects measurement of provider contracting risk-sharing agreements 7/3/2019 12:00:00 AM ...

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    • Authors: Thomas Messer
    • Date: Jul 2019
    • Competency: External Forces & Industry Knowledge; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Payment models; Health & Disability>Provider networks; Health & Disability>Provider risk
  • Valuation of Care Management Vendors
    Valuation of Care Management Vendors Methods and assumptions used in the valuation of savings by external care vendors 5/1/2020 12:00:00 AM ...

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    • Authors: Rick S Pawelski
    • Date: May 2020
    • Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
  • 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 ...

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    • 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
  • A Regulatory Perspective on Rate Review Before and After the Affordable Care Act
    A Regulatory Perspective on Rate Review Before and After the Affordable Care Act A Regulatory Perspective on Rate Review Before and After the Affordable Care Act Patient Protection and Affordable ...

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    • Authors: Annette James
    • 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
  • Health Care Reform: Essential Health Benefits and Actuarial Value
    Health Care Reform: Essential Health Benefits and Actuarial Value Essential Health Benefits and Actuarial Value Patient Protection and Affordable Care Act= PPACA=Affordable Care Act;Health care ...

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    • Authors: Catherine Knuth
    • 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
  • Medicare Advantage: Five Years after the ACA
    Medicare Advantage: Five Years after the ACA Medicare Advantage and ACA Patient Protection and Affordable Care Act= PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss ...

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    • Authors: Andrew Mueller, Yingxuan Li
    • 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
  • The Individual Market and ACA Products: Starting from First Actuarial Principals
    The Individual Market and ACA Products: Starting from First Actuarial Principals Individual Market and ACA Products Actuarial rating principals Patient Protection and Affordable Care Act= PPACA= ...

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    • Authors: Kurt Wrobel
    • 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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