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Health Care Reform: Essential Health Benefits and Actuarial Value
pre- ACA policies to do so.) In addition, the U.S. Depart- ment of Health and Human Services (HHS) ... required to cover the greater of one drug per U.S. Pharmaceutical (USP) category or class or the same ...- Authors: Catherine Knuth
- 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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Health Watch, June 2017, Issue 83
Health Section Events By Karen Shelton I S S U E 8 3 • J U N E 2 0 1 7 Health Watch 2 | JUNE ... States in 2010 2. $56 billion on sepsis care in U.S. hospitals every day in 2011 3. 30 percent projected ...- Authors: Society of Actuaries
- Date: Jun 2017
- 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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ACA Impact on Employers - The road ahead and the road behind
size employers constitute 2 per- cent each of all U.S. employers and are subject to phased-in employer ... the United States. Per the report2 issued by the U.S. Census Bureau, over 169 million buy employment-based ...- Authors: Sujaritha Tansen, Brian Stentz
- 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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Epilogue
no magic bullet for curing the problems of the U.S. health care system. However, after years of uncontrolled ... The views expressed herein are those of the author(s) and not necessarily the views of FTI Consulting ...- Authors: Jim Toole, Mary Carmen Easterwood
- Date: Aug 2015
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance
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Surplus and the ACA
construct intended to be an early warn- ing system for U.S. insurance regulators and provide capital adequacy ... Considerations for a Managed Care Orga- nization”, © 2000 Milliman and Robertson, Inc. • NAIC RBC article: ...- Authors: Daniel Pribe
- 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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Medicaid Encounter Data: The Next National Data Set
20 percent of the U.S. population and accounts for more than 16 percent of all U.S. health care spending ... information relating to the receipt of any item(s) or service(s) by an enrollee under a contract between ...- Authors: Jennifer Gerstorff, Sabrina Gibson
- Date: Sep 2016
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Internal forces and business performance
- Publication Name: In The Public Interest
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Public financing - Health & Disability
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An Actuarial Model to Improve Health and Reduce Costs
Beckman Chronic disease accounts for 86 percent of U.S. health care costs and an ever-increasing share of ... Diabetes Association, Economic Costs of Diabetes in the U.S. in 2012, http://care.diabetesjournals.org/cont ...- Authors: Ken Beckman
- Date: Oct 2017
- Competency: Leadership>Thought leadership; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy
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Defining Best-In-Market Health Opportunities
Marketing Moderator: DALE H. YAMAMOTO Panelists: MINDY S. KAIREYt Recorder: DALE H. YAMAMOTO Summary: Health ... it all in the past, so, bear with us. Ms. Mindy S. Kairey: We're going to spend a little bit more than ...- Authors: Dale Yamamoto, Mindy S Kairey
- Date: Jun 1998
- 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; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance
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Taxes and Fees Introduced by the ACA
classes of insur- ers. As shown in the illustrative table in Figure 1, the amount by which the insurer would ... cases. The industry made an effort to lobby the U.S. De- partment of Health and Hu- man Services (HHS) ...- Authors: Michael Gaal
- 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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Give Me Some Credibility: Addressing the Challenge of Volatility in Value-Based Contracts—Part 2
improve credibility enough that a larger provider's own prior period experience can be used directly, ... for providers to trust. Questions of the form “it's not clear or fair that I should be measured based ...- Authors: Maria Knox, James Pisko, Keith Passwater
- Date: May 2023
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Predictive Analytics; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques