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Medicare Advantage Star Ratings: Expectations for New Organizations
traditional FFS Medicare Part A (hospital and long- term care services) and Part B (outpa- tient and professional ... Prescription Drug Plans (PDPs), Program of All- Inclusive Care for the Elderly (PACE) plans, Cost plans, Medicare- ...- Authors: Kelly Backes, Julia Friedman, Dustin Grzeskowiak, Elizabeth Phillips, Patricia Zenner
- Date: Jun 2018
- Competency: External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>Internal forces and business performance; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Social Insurance>Medicare
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ASOPs, Anti- Selection, Affordability and ACA Altern
related to the implementation of the Afford- able Care Act (ACA). At the time, there was a general sense ... that it’s just they haven’t prioritized health care because right now everybody’s healthy. Nobody actually ...- Authors: Gregory Fann
- Date: Nov 2016
- Competency: Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Actuarial Profession>Standards of practice; Health & Disability>Health care; Health & Disability>Health risks; Public Policy; Public Policy
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Letter from the Editor
previously undiagnosed at-risk patients to improve care management more efficiently. The next two articles ... marketed toward filling in the “holes” in health care coverage. Rebecca Owen has authored an article ...- Authors: Marilyn Medved McGaffin
- Date: Mar 2017
- Competency: Communication>Written communication; Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Influence decisions
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance
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Letter from the Editor
co- authored an article on the role of palliative care for patients with serious illness. It is an area ... of us who have ever had a loved one use hospice care, this article will have a special interest. It ...- Authors: Marilyn Medved McGaffin
- Date: Nov 2016
- Competency: Communication>Written communication; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Actuarial Profession>Best practices; Actuarial Profession>Standards of practice
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Chairperson’s Corner
professional organization, such as the DMAA-The Care Continuum Alliance or the American Society of ... Pricing (Parts C & D), Disability and Long Term Care Pricing, Professionalism and Valuation. There are ...- Authors: Jennifer Gillespie
- Date: May 2009
- Competency: Communication; External Forces & Industry Knowledge>General business skills; Leadership>Professional network leverage; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Actuarial Profession>Competencies; Actuarial Profession>Professional development
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Letter from the Editors
notable changes likely to occur in the U.S. health care system, it’s interesting to see how other coun- ... issues. For better or for worse, the U.S. health care system is unique among those used in the world’s ...- Authors: Grady Catterall, Mary Kindel Van der Heijde
- Date: Feb 2010
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Leadership; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional associations; Global Perspectives; Modeling & Statistical Methods
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Happy 30th Birthday, Health Section!
Happy 30th Birthday, Health Section! A look back at the 30 years since the Health Section was ... payers including provider consulting, Accountable Care Organizations, pharmaceuticals, disease management ...- Authors: Society of Actuaries
- Date: May 2011
- Competency: Leadership>Thought leadership; Professional Values; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional associations; Economics>Health economics
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Enterprise Risk Management:One size does not fit all
Looking forward, the impact of the Affordable Care Act (ACA) on MLRs will need to be consid- ered. ... life, or property and casualty (P&C)). Health care is considered a short- tailed line of business, ...- Authors: Mark W Whitford
- Date: Jan 2013
- Competency: Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Annuities>Investment strategy - Annuities; Enterprise Risk Management>Portfolio management - ERM; Finance & Investments>Asset allocation; Finance & Investments>Asset liability management; Finance & Investments>Investments
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ORSA 101 for Health Actuaries
And those of us whose work is touched by health care reform tend to spend a lot of our time reading ... the risk from under- pricing in the Affordable Care Act (ACA) markets in 2014 may be modest. Separately ...- Authors: Daniel Perlman, Douglas Norris
- Date: May 2016
- Competency: External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>Internal forces and business performance; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Enterprise Risk Management>Risk measurement - ERM; Enterprise Risk Management>Strategic risks
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Is there currently an underwriting cycle?
substantial federal grants under the Affordable Care Act (ACA) to enhance their rate review procedures ... for certain risks and given the current health care environment. This analysis considers the 1999–2011 ...- Authors: Mark Shaw
- Date: Jan 2013
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Enterprise Risk Management>Capital management - ERM; Enterprise Risk Management>Systematic risk; Health & Disability>Health insurance