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  • Is Your Integrated Delivery System Throwing Away Free Money?
    Is Your Integrated Delivery System Throwing Away Free Money? Article explores why many integrated delivery systems are struggling and what actions they need to take to succeed. Medicare;aligned ...

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    • 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
  • A Comparison of Risk Scoring Recalibration Methods
    A Comparison of Risk Scoring Recalibration Methods This article compares three potential approaches to determining new coefficients for health-based risk scoring models: full recalibration, ...

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    • Authors: Geoffrey Hileman
    • Date: Dec 2015
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Predictive Analytics and Futurism Newsletter
    • Topics: Health & Disability>Health insurance; Health & Disability>Payment models; Modeling & Statistical Methods>Regression analysis
  • Medicaid and the ACA
    Medicaid and the ACA Medicaid and the ACA Patient Protection and Affordable Care Act= PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care ...

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    • Authors: Rebecca Owen
    • 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
  • Providers: Reorganize and Refinance
    Providers: Reorganize and Refinance A rethinking of current provider reimbursement, focusing on incentives instead of simply cutting fees. The recommended 2-pronged approach would feature ...

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    • Authors: Jill Van Den Bos
    • Date: Sep 2010
    • Competency: Leadership>Thought leadership; Results-Oriented Solutions>Assess decision effectiveness; Strategic Insight and Integration>Big picture view
    • Publication Name: Health Watch
    • Topics: Economics>Health economics; Health & Disability>Health care quality; Health & Disability>Payment models; Public Policy
  • Health Watch, February 2018, Issue 85
    Health Watch, February 2018, Issue 85 Read the February 2018 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section ...

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    • Authors: Society of Actuaries
    • Date: Feb 2018
    • 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
  • 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 ...

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    • 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
  • The ACA’s Medical Loss Ratio Provisions: Looking Back
    The ACA’s Medical Loss Ratio Provisions: Looking Back The ACA’s Medical Loss Ratio Provisions Patient Protection and Affordable Care Act= PPACA=Affordable Care Act;Health care reform;Health ...

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    • Authors: Rowen Bell
    • 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
  • 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 ...

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    • 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
  • Pricing Issues Resulting from Budget Setting and Stoploss in ACO Arrangements
    Pricing Issues Resulting from Budget Setting and Stoploss in ACO Arrangements This article will consider several issues arising from ACO budgeting and pricing of stoploss coverage, including: 1) ...

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    • 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
  • 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 ...

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    • 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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