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Issue Brief: Changing Financial Risks for Medigap Insurance, Part 1
patients who deferred certain types of care or simply sought less care than they normally would (or should) ... financial improvements due to delayed and averted care in 2020 and 2021 than did other types of health ...- Authors: Kristi Bohn
- Date: Mar 2024
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health insurance
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Issue Brief: Changing Financial Risks for Medigap Insurance, Part 2
(snowbirds, for example); and cover their major health care needs without MA’s utilization reviews and the risk ... as well as likely delays in receiving necessary care.[4] Providers may also appreciate Medigap-covered ...- Date: Mar 2024
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health insurance; Public Policy; Public Policy
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How blockchain technology will disrupt the PBM-payer-pharmacy relationship
pharmaceutical industry has many stakeholders. The primary purpose of the PBM is to serve as an intermediary ... the focus of this paper is on the private health care space. THE ORIGIN OF PBMS PBMs as we know them ...- Authors: Brian Anderson, Michael DiPrima , Greg Callahan
- Date: Apr 2020
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Technology & Applications; Technology & Applications>Blockchain & cryptocurrency
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Provider Risk-Sharing and Random Noise
infrastructure. Pricing actuaries will need to estimate the direct effect of random fluctuations, the indirect effect ... Some- times Shi Accountability to HMOs. Managed Care, Dec. 1, 2000. https://www .managedcaremag.com ...- Authors: Thomas Messer
- Date: Jul 2019
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Payment models; Health & Disability>Provider networks; Health & Disability>Provider risk
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Biosimilars, Part 3: Humira Biosimilar Launches
patients everywhere. prescription drug costs, health care payment reforms, medical expenses By Gregory Warren ... inclusion in formularies so patients can have the care access they need. To remove Humira from your formulary ...- Authors: Tony Pistilli, Greg Warren
- Date: Nov 2023
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health insurance; Public Policy; Public Policy; Public Policy
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The Future of Health Actuaries
financial management for insurance companies, managed care organizations and employee bene- fit plans. We should ... to under- stand patterns of care and to demonstrate how and why health care is delivered differently in ...- Authors: Kara Clark
- Date: Apr 2004
- Competency: Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Actuarial Profession>Alternative careers
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Biosimilars, Part 4: The Financial Impact
Biosimilars, Part 4: The Financial Impact Savings from biosimilars have accelerated significantly ... year’s big event. prescription drug costs, health care payment reforms, medical expenses By Gregory Warren ...- Authors: Greg Warren, Tony Pistilli
- Date: Nov 2023
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health insurance; Public Policy; Public Policy; Public Policy
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Is Your Integrated Delivery System Throwing Away Free Money?
of both the delivery and the insur-ing of health care should be powerful. That is the theory behind an ... explain why. Optimizing value in an integrated health care delivery system requires aligning the financial ...- Authors: Karan Rustagi
- Date: Feb 2018
- Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional development; Health & Disability>Payment models; Social Insurance>Medicare
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Claims Reserve Margin in the Health Annual Statement: A Review of 2016–2021
Claims Reserve Margin in the Health Annual Statement: A Review of 2016–2021 In preparing ... patterns may vary by region or size of the managed care organization. Additionally, certain states may have ...- Authors: Robert Lang, Elliot McLeRoy
- Date: Nov 2023
- Competency: Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Financial Reporting & Accounting; Financial Reporting & Accounting>Statutory accounting; Health & Disability; Health & Disability>Claims - Health & Disability
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October 2019 issue of Health Watch
18|11: What Can We Do About the Cost of Health Care? We embarked on this nearly two years ago with ... to insert health care actuaries into the discussion on the rising cost of health care. This is not a short-term ...- Authors: Society of Actuaries
- Date: Oct 2019
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability