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Underwriting Gain in Managed Medicaid: Starting the Conversation
Underwriting Gain in Managed Medicaid: Starting the Conversation According to the Actuarial ... 49 (ASOP 49), actuarially sound Medicaid managed care capitation rates will include a provision for underwriting ...- Authors: Jaredd Martin Keith Simons, James Randolph Piekut
- Date: Nov 2019
- Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Modeling & Statistical Methods; Modeling & Statistical Methods>Forecasting; Modeling & Statistical Methods>Scenario generation; Modeling & Statistical Methods>Simulation
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The Retirement Needs Framework: Issues for Health Actuaries
health, changes in care needs, changes in the availability of family members to provide care, changes in housing ... decisions. Issues with Regard to the Frail Elderly Care for the frail elderly is a major prob- lem for which ...- Authors: Anna M Rappaport
- Date: Dec 2000
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Long-term Care; Modeling & Statistical Methods
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2019 Spring Health Meeting In Review
Academy of Actuaries. Used with permission. The primary drafter of this publication is Academy Senior Health ... strengthen insurance markets under the Afford- able Care Act (ACA) or to replace the ACA marketplaces and/or ...- Authors: Rick S Pawelski
- Date: Nov 2019
- Competency: External Forces & Industry Knowledge; Professional Values; Relationship Management; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Actuarial Profession; Actuarial Profession>Professional development
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Digital Health
technologies to enhance the efficiency of health care delivery. It may include hardware and software ... researchers, scientists with expertise in health care, engineers, social scientists, public health representatives ...- Authors: Marilyn Medved McGaffin
- Date: Feb 2020
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Technology & Applications; Technology & Applications>Analytics and informatics; Technology & Applications>Cyber risk; Technology & Applications>Telematics; Technology & Applications>Wearables & implants
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When Affordability Savings Do Not Reduce Costs
observations will be closer to the average. Health care actuaries need to understand and be able to mitigate ... costs due to an intervention.” APPLICATION TO HEALTH CARE A 2006 study by the Agency for Healthcare Research ...- Authors: Tony Pistilli
- Date: Dec 2020
- Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Modeling & Statistical Methods>Forecasting; Modeling & Statistical Methods>Regression analysis; Predictive Analytics>Modeling techniques; Predictive Analytics>Quality control & model governance
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Risk Adjustment: The Details and Why They Matter
Risk adjustment uses algorithms to predict health care costs based on the relative actuarial risk of enrollees ... plan premium payments based on expected health care costs. Some of the payment method- ology currently ...- Authors: Karena Weikel
- Date: Feb 2018
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks
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Incorporating Random Effects to Reduce Variance in Risk Score Estimation
across commercial, Medicare and Medicaid managed care lines of business, including risk-adjusted payments ... projection, measuring savings and assessing quality of care for members. Health risk scores are generally a ...
- Authors: Robert Jason Reed (Jason)
- Date: Jul 2021
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Modeling & Statistical Methods>Estimation methods; Modeling & Statistical Methods>Regression analysis; Predictive Analytics>Modeling techniques
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“Credibility”—The Health Actuary’sNemesis or Friend?
. . . . . . . . . . . . . . . . . 12 “Managed Care” Capitation and Beyond”—Two-Day Seminar . 12 Minutes ... emphasis among casualty actu- aries. However, direct application to health insurance is not appropriate ...- Authors: Thomas J Stoiber
- Date: Jun 1998
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Actuarial Profession>Competencies; Health & Disability
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The Potential of Infra-Low Frequency Neurofeedback to Reduce Medical Claim Costs and Dramatically Improve Patients’ Lives
the implications for reducing high mental health care costs.[1] The study successfully used neurofeedback ... significant implications for lowering mental health care costs. It has been shown to be effective for a number ...
- Date: Jul 2023
- Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health insurance
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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