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Validating a Novel Health Insurance Fraud Detection Method
Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for ...- Authors: Robert D Lieberthal, Elias
- Date: Aug 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; 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: Risk Management
- Topics: Economics>Health economics; Enterprise Risk Management; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Data mining; Predictive Analytics
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The Development of WeChat Marketing and Distribution of Insurance Products in China
The Development of WeChat Marketing and Distribution of Insurance Products in China WeChat is gradually becoming the main force of insurance online marketing for insurance products in China. Life ...- Authors: Society of Actuaries
- Date: Dec 2018
- Competency: External Forces & Industry Knowledge>External forces and business performance
- Topics: Health & Disability>Health insurance; Life Insurance>Marketing and distribution - Life Insurance
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Discounted Unpaid Losses: A Rate or a Curve?
Discounted Unpaid Losses: A Rate or a Curve? The article describes changes to the computation of discounted unpaid losses (claim reserves) as a result of the 2017 tax legislation.- Authors: Kristin R Norberg
- Date: Jun 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
- Publication Name: Taxing Times
- Topics: Financial Reporting & Accounting>Tax accounting; General Insurance (Property & Casualty)>Reserves - General Insurance; Health & Disability
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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 ...- 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
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Future of Group Benefits in Canada
Future of Group Benefits in Canada By Melissa Carruthers A description of the keys to future success in the Canadian group benefits business. Consumer-driven health plans;Group health plans; ...
- Authors: Melissa Carruthers
- Date: May 2018
- Competency: Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Effective decision-making; Strategic Insight and Integration>Influence decisions; Strategic Insight and Integration>Management partnership; Strategic Insight and Integration>Strategy development
- Publication Name: Innovators & Entrepreneurs
- Topics: Health & Disability>Health insurance
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Improving Medicare Advantage Star Ratings: An Analytical Framework
Improving Medicare Advantage Star Ratings: An Analytical Framework This paper outlines a framework for assisting a STARS manager in implementing a quantitative approach to prioritize stars ...- Authors: Puneet Budhiraja, Rajesh Munjuluri
- Date: Oct 2018
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability; Technology & Applications>Analytics and informatics
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Self-Insurance Strategic Initiative Report
Self-Insurance Strategic Initiative Report This monograph explains the ways actuaries are or could be involved in the self-insured employer health plan marketplace today and in the future. Health ...- Authors: Society of Actuaries, John Mange, Kristi Bohn, Hobson Carroll, Michael A Kemp, Mehboob Khoja, David E Olsho, Shaun Peterson, Nicholas Sarneso, Brent Seiler, Joseph Slater, Dustin Tindall, David Wilson, Gregory J Sullivan
- Date: Jun 2018
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Results-Oriented Solutions>Actionable recommendations
- Topics: Health & Disability>Health insurance
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Predicting High-Cost Members in the HCCI Database
Predicting High-Cost Members in the HCCI Database Using the Health Care Cost Institute (HCCI) database, we examined which characteristics best predict and describe high-cost members. September ...
- Authors: Brian Hartman
- Date: Sep 2018
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context
- Topics: Health & Disability>Health risks
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Model of Long-Term Health Care Cost Trends in Canada
Model of Long-Term Health Care Cost Trends in Canada The Canadian Institute of Actuaries (CIA) and the Society of Actuaries (SOA) are pleased to make available a resource model that provides ...
- Authors: Society of Actuaries, 107929_firstname Canadian Institute of Actuaries
- Date: Mar 2018
- Competency: External Forces & Industry Knowledge
- Topics: Health & Disability>Health care
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Letter From the Editor
Letter From the Editor Editor letter about what constitutes a good Health Watch article and summary of articles. Health care reform;Health insurance;Health policy 6442480946 2/1/2018 12:00:00 AM ...- Authors: Gregory Fann
- Date: Feb 2018
- Competency: Communication>Written communication; Leadership>Thought leadership; Professional Values>Ethical standards
- Publication Name: Health Watch
- Topics: Health & Disability>Health care