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Design and Pricing of Tiered Network Health Plans
Design and Pricing of Tiered Network Health Plans This article discusses the advantages, logistical concerns, and pricing formulas of implementing a TNHP, in which members pay less for treatment ...- Authors: Peter Horman
- Date: May 2009
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health care quality; Modeling & Statistical Methods
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Letter from the Editor
Letter from the Editor Recap of content contained in the January 2014 issue of the Health Watch newsletter. Health insurance;Health care costs;Medicaid;Patient Protection and Affordable Care Act ...- Authors: Kurt Wrobel
- Date: Jan 2014
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Professional Values>Practice expertise
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Public Policy
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Bariatric Surgery Holds Promise for Patients and for Payors
Bariatric Surgery Holds Promise for Patients and for Payors An economic analysis of bariatric surgery and health care costs supports the case for health plans to cover these procedures. Health ...- Authors: John Dawson, Pierre-Yves Cremieux, Arindam Ghosh
- 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: Economics>Health economics; Experience Studies & Data; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining
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The State of Predictive Analytics in U.S. Health care
The State of Predictive Analytics in U.S. Health care Health care predictive analytics varies between payers and providers as well as being a powerful tool in business decision modeling. Data ...- Authors: Marilyn Medved McGaffin
- Date: Nov 2016
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks; Predictive Analytics
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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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Letter from the Editor
Letter from the Editor Recap of content contained in the May 2013 issue of the Health Watch newsletter. Accountable care organizations= ACO;Health insurance;Medicaid;Payment models=Health care ...- Authors: Kurt Wrobel
- Date: May 2013
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Professional Values>Practice expertise
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Public Policy
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Health Risk Assessments in a Protected Environment
Health Risk Assessments in a Protected Environment A discussion of permissible use and collection of genetic information for Health Risk Assessments and wellness programs under the Genetic ...- Authors: John C Cameron
- Date: May 2010
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Professional Values>Ethical standards
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks; Public Policy; Technology & Applications>Analytics and informatics
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New SOA Research Study Evaluates Cost Impact of Drug Therapy for Crohn’s Disease
New SOA Research Study Evaluates Cost Impact of Drug Therapy for Crohn’s Disease This article discusses a study of the impact of the drug infliximab on Crohn's disease patients. This study ...- Authors: Steven Siegel
- Date: May 2009
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Leadership>Professional network leverage; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Actuarial Profession>Academic partnerships; Experience Studies & Data; Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care
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Assessing Prescription Opioid Risk with Predictive Analytics
Assessing Prescription Opioid Risk with Predictive Analytics We highlight a new approach leveraging predictive analytics to identify high risk and rising risk opioid users for more effective ...- Authors: Joseph Boschert, Andrew Gaffner, Barbara Collier
- Date: Oct 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making; Strategic Insight and Integration>Influence decisions; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Demography>Population data; Experience Studies & Data; Health & Disability>Health information technology; Modeling & Statistical Methods>Data mining; Predictive Analytics; Technology & Applications>Analytics and informatics; Health & Disability>Electronic medical record
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Industry Perspective Consumer Protection -Continuation of Benefits in Event of HMO Insolvency
Industry Perspective Consumer Protection -Continuation of Benefits in Event of HMO Insolvency Discussion of insolvency provision added to reinsurance agreements to insure the continuation of ...- Authors: Harry L Sutton
- Date: Dec 2000
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance