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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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At the Intersection of Risk Adjustment and Social Determinants of Health
At the Intersection of Risk Adjustment and Social Determinants of Health Interview of people knowledgeable about risk adjustment and the use of social determinants of health with that context for ...- Authors: Sudha Shenoy, Gail Stone
- Date: Mar 2019
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions
- Publication Name: Health Watch
- Topics: Social Insurance>Medicaid
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What Will Be the Impact of theNew Medicare PrescriptionDrug Benefit?
What Will Be the Impact of theNew Medicare PrescriptionDrug Benefit? This article provides an introduction to the Medicare Prescription Drug, Improvement and Modernization Act of 2003 and looks ...- Authors: Corey Berger
- Date: Mar 2005
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Social Insurance>Medicare
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Risk Adjustment in State Medicaid Programs
Risk Adjustment in State Medicaid Programs This article discusses some of the most important considerations in implementing risk adjustment within a Medicaid Managed Care program. From Health ...- Authors: Robert Damler, Ross Winkelman
- Date: Jan 2008
- Competency: Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Social Insurance>Medicaid
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The Modernization of Medigap Plans–Managing the Change
The Modernization of Medigap Plans–Managing the Change This article discusses planning for the changes that will occur with the new Medigap policies, which will be effective on or after June 1, ...- Authors: Gail M Lawrence
- Date: Jan 2009
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Social Insurance>Medicare
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Generic Dispensing Rates: Silver Bullet No More?
Generic Dispensing Rates: Silver Bullet No More? A summary of the driving forces behind, and effects of, the historical increases and future expectations of Generic Dispensing Rates.- Authors: Troy Filipek
- Date: May 2010
- Competency: External Forces & Industry Knowledge>External forces and business performance; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Economics>Behavioral economics; Economics>Health economics; Social Insurance>Medicare
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Medicare Supplement: Critical Factors for Success
Medicare Supplement: Critical Factors for Success An overview of the Medicare Supplement landscape and the critical factors for successfully pricing and managing this product line amidst the ...- Authors: James Galasso, John S Cathcart, Sudha Shenoy, Kenneth Clark
- Date: Jan 2011
- Competency: External Forces & Industry Knowledge; Professional Values>Practice expertise
- Publication Name: Health Watch
- Topics: Public Policy; Public Policy; Social Insurance>Government-funded healthcare; Social Insurance>Medicare
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Payment Reform Under The Medicare-Medicaid Financial Alignment Demonstration
Payment Reform Under The Medicare-Medicaid Financial Alignment Demonstration This article focuses on the capitation rate development methodology for the Medicare-Medicaid Financial Alignment ...- Authors: Michael Cook, Shelly Brandel
- Date: May 2013
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Public Policy; Social Insurance>Medicaid; Social Insurance>Medicare
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Medicaid Innovation: The Need for Actuaries in the Medicaid Program
Medicaid Innovation: The Need for Actuaries in the Medicaid Program Background on Medicaid and description of recent changes in the program. Medicaid;Payment Reform;Payment Models;Social ...- Authors: Christine Bach
- Date: May 2016
- Competency: Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Social Insurance>Medicaid
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Potential Membership Shifts for Medicare Prescription Drug Plans
Potential Membership Shifts for Medicare Prescription Drug Plans Changes in CMS requirements for 2011 Medicare Part D plans aimed at reducing confusion surrounding the PDP selection process by ...- Authors: Shelly Brandel
- Date: Jan 2011
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Public Policy; Social Insurance>Medicare