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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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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
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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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Health Watch, Issue 72, May 2013
ticipate in the major changes occurring within the U.S. health care system. I’ll also expand the focus ... we exceed the tar- get. For example, as shown in Table 1, the hospital provider partner can exercise a ...- Authors: Society of Actuaries
- Date: May 2013
- Competency: Results-Oriented Solutions>Actionable recommendations
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
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New Contract Medicare Star Ratings: Why The Sudden Cliff?
TIMELINE FOR MEDICARE ADVANTAGE STAR RATINGS The table below illustrates the various aspects of the Star ... impact a Medi- care Advantage plan financially. Table A1 below gives the breakdown of the Quality Bonus ...- Authors: Suzanna-Grace Sayre, Danielle Beierle
- Date: Jan 2020
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance
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Medicaid and the ACA
Medicaid and the ACA Medicaid and the ACA Patient Protection and Affordable Care Act= PPACA=Affordable ... to interface between the On June 28, 2012, the U.S. Supreme Court issued a deci- sion that while the ...- Authors: Rebecca Owen
- 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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A Regulatory Perspective on Rate Review Before and After the Affordable Care Act
released separate guid- ance indicating that the U.S. Department of Health and Hu- man Services (HHS) ... eration of Independent Business v. Sebelius, the U.S. Supreme Court upheld two of the main provisions ...- Authors: Annette James
- 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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Valuation of Care Management Vendors
Valuation of Care Management Vendors Methods and assumptions used in the valuation of savings ... costs changed that. As an increasing part of the U.S. gross domestic product and American workers’ paychecks ...- Authors: Rick S Pawelski
- Date: May 2020
- Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
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Impact Of Medical Technology On Health Care Programs
depen- dent on geographic area. Almost half of all U.S. AIDS cases so far have occurred in San Francisco ... for some diseases. This would not be easy in the U.S. where we are accustomed to receiving costly treatment ...- Authors: John K Ahrens, William A Atchley, Robert W Morey, Mark Troutman
- Date: Oct 1985
- Competency: Strategic Insight and Integration>Strategy development
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health care quality; Health & Disability>Health insurance