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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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Outpatient Facility Reimbursement
Outpatient Facility Reimbursement Review of reimbursement methodologies APGs, APCs, Medicare ASC, discount on charges, commercial hybrid, methods and trends in contracting, impact on trent, ...- Authors: Brian Small
- Date: Oct 2002
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Health & Disability>Payment models
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An Interview: Dr. Uwe Reinhardt
An Interview: Dr. Uwe Reinhardt In this interview Dr. Reinhardt shares his thoughts on the role he believes actuaries should take in the health care system reforms. Assumptions;Episode-based ...- Authors: Mary Kindel Van der Heijde, Douglas Norris
- Date: Sep 2009
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Leadership>Thought leadership; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Actuarial Profession>Traditional careers; Enterprise Risk Management; Health & Disability>Health risks; Health & Disability>Payment models
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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 ...- 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
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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 ...- 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
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New Report on Evaluating Payment Models for High-Cost Curative Therapies
New Report on Evaluating Payment Models for High-Cost Curative Therapies This short article presents the latest SOA health research report on alternative payment models for high-cost curative ...- Authors: Didier Serre
- Date: Mar 2019
- Competency: Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Payment models
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Direct Primary Care: Good for What Ails Us
Direct Primary Care: Good for What Ails Us Discussion of direct primary care and how it helps with several challenges in health care today. DPC improves care coordination, improves outcomes, ...- Authors: Gayle Brekke
- Date: May 2016
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Leadership>Thought leadership; Professional Values>Public interest representation; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health insurance; Health & Disability>Payment models
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Value-Based Care: The Role of the Health Care Provider Actuary A Health Section Strategic Initiative
Value-Based Care: The Role of the Health Care Provider Actuary A Health Section Strategic Initiative This interview article summarizes the work being done by a Health Section Strategic Initiative ...- Authors: Gregory Fann
- Date: Feb 2018
- Competency: Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Payment models
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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 ...- 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
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Value Based and Accountable Care: The Actuarial and Clinical Role in Building a Sustainable Model
Value Based and Accountable Care: The Actuarial and Clinical Role in Building a Sustainable Model As providers are considering accountable and value based care models, it is critical to ...- Authors: Mark Bethke, James M Whisler, Amanda Holland
- Date: May 2013
- Competency: Leadership>Change management; Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Payment models; Modeling & Statistical Methods>Forecasting; Modeling & Statistical Methods>Sensitivity testing; Modeling & Statistical Methods>Value at risk - Modeling & Statistical Methods; Public Policy