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  • Using the Internet as a Pricing Tool
    change goes into effect?” If there is only one primary payor, then the answer lies in the applicable contractual ... Medicaid populations can be found on the Health Care Financing Administration site. (http://www.hcfa ...

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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
  • Seasonal Flu Impacts: Flu Science Meets Actuarial Science
    very broad (and sometimes deep) health and health care cost implications. As individuals, our interest ... and virulence of the virus each year. As health care actuaries, our interest is focused on understanding ...

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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
  • Don’t Forget the Data
    great deal of attention has been given to all health care prod- ucts. As the “cradle to grave” wel- fare ... suit. The Last Decade During the ‘90s, key health care products have had mixed fortunes. Critical illness ...

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    • Authors: Robert Bachler
    • Date: Aug 2000
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care
  • Chairperson's Corner
    learn about the clinical matters underlying health care claims. The boot camps were a great success this ... increased educational focus on include: - The Affordable Care Act’s (ACA) impact on commercial pricing and reserving ...

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    • Authors: Donna Kalin
    • Date: Jan 2014
    • Competency: Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care
  • Estimating IBNR from Authorized Bed Days
    per day of acute, sub-acute and other levels of care. Reviewing our historical inpa- tient costs, incurred ... the estimation method, costs include all inpatient care being esti- mated, and days are from the authorization ...

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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
  • The Actuary and Health Insurance Mergers and Acquisitions
    medicare supplement, disability, and long-term care business. This activity is likely to continue in ... companies such as a marketing company or managed care company may be part of the sale. The situation will ...

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    • Authors: James O'Connor
    • Date: Apr 2001
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance
  • Applying Diagnosis-Based Predictive Models to Group Underwriting
    information to accurately measure expected health care consumption to support efficient alloca- tion of ... 38 million members who were eligible for health care insurance for at least 1 month in both 1997/98 (Year ...

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    • Authors: Randall P Ellis, Marilyn Kramer
    • Date: Aug 2003
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability
  • Comparison of Risk Adjusters
    Comparison of Risk Adjusters Analysis of diagnosis and pharmacy-based methods of health ... medical diagnosis codes to adjust payments to managed care plans for Medicaid enrollees. Employers are using ...

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    • Authors: Robert Cumming
    • Date: Oct 2002
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability
  • Statistical Tools for Actuaries?First in New Series of Guides Available
    Statistical Tools for Actuaries?First in New Series of Guides Available Recognizing an opportunity ... perspective. The guide includes an overview of health care liabilities and the completion factor method, as ...

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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
  • Health Section Issues New IBNR Study
    Health Section Issues New IBNR Study Summary of the health section council’s research project ... traditional lag, Paid PMPM, etc.) is applied. 6. Care should be taken in determining which IBNR method ...

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    • Authors: Steven Siegel, Cabe Chadick
    • Date: Feb 2010
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Assess decision effectiveness; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Actuarial Profession>Standards of practice; Financial Reporting & Accounting; Health & Disability>Health care; Modeling & Statistical Methods>Modeling efficiency