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  • HCFA & Medicare + Choice: Contract Year 2001 Changes
    HCFA & Medicare + Choice: Contract Year 2001 Changes Outline of changes to the Adjust ... Choice: Contract Year 2001 Changes Outline of changes to the Adjust Community Rate ACR Proposal process ...

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    • Authors: Anant Galande
    • Date: Aug 2000
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Social Insurance>Medicare
  • Design and Pricing of Tiered Network Health Plans
    Design and Pricing of Tiered Network Health Plans This article discusses the advantages, logistical ... logistical concerns, and pricing formulas of implementing a TNHP, in which members pay less for treatment from ...

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    • 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
  • Moneyball and the Actuarial Profession
    Moneyball and the Actuarial Profession Author compares in-depth statistical review of baseball ... and the Actuarial Profession Author compares in-depth statistical review of baseball team to the actuarial ...

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    • Authors: Kurt Wrobel
    • Date: Apr 2004
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Experience Studies & Data
  • Using the Internet as a Pricing Tool
    Using the Internet as a Pricing Tool Using the Internet as a Pricing Tool clinical background information ... information, defining the change in coverage, collecting data, data quality and data limitations. Issue No ...

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    • Authors: Application Administrator
    • Date: Dec 2000
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Experience Studies & Data; Technology & Applications
  • Current Issues In Stop Loss Market
    What are the current trends and issues facing the market as it regains profitability? The panel of Ray Marra ... Marra of The Hartford, Mike McLean of Medical Risk Managers (MRM), and Jerry Winkelstein, who is an independent ...

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    • Authors: Daniel Wolak
    • Date: Sep 2001
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Reinsurance>Stop-loss insurance
  • Statistical Tools for Actuaries?First in New Series of Guides Available
    Series of Guides Available Recognizing an opportunity to help serve its members in this age of increased ... oversight, the Health Section of the Society of Actuaries commissioned a series of guides on the use of statistical ...

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    • Authors: Steven Siegel
    • Date: Jan 2008
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care
  • Seasonal Flu Impacts: Flu Science Meets Actuarial Science
    Science Meets Actuarial Science By Bethany McAleer The seasonal flu comes every year with very broad (and ... cost implications. As individuals, our interest in the flu is focused on making sure we’re following recommendations ...

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    • Authors: Bethany McAleer
    • Date: Oct 2018
    • Competency: 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 care
  • The Bottom Line on BehavioralHealth Care Costs
    The Bottom Line on BehavioralHealth Care Costs This article reviews the cost of behavioral health care ... care and looks at how the involvement of Primary Care Physicians leads to a less efficient and effective ...

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    • Authors: Stephen P Melek
    • Date: Mar 2005
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care
  • Assessing Prescription Opioid Risk with Predictive Analytics
    Barbara Collier and Joseph Boschert According to the Centers for Disease Control and Preven-tion (CDC) ... more than 115 people die each day in the United States as a result of opioid over- dose and that prescription ...

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    • 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
  • Estimating IBNR from Authorized Bed Days
    accuracythan if estimated from member-ship, given the “right” business environment. This gives rise to ... confidence in current month expense estimates. The success of estimating from days is tied to many factors ...

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    • Authors: Kevin L Pedlow
    • Date: Apr 2001
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care