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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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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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Value for Money from the Top 20? A Critical Examination of Therapeutic Impact and Value of Top-Selling Drug Products against their Competitors
powerful forces act on the provision of health care in the modern world. The first is the evidence-based ... guidelines. Prescribing for hypertension in primary care clinics at an internal medicine referral clinic ...- Authors: Alan Cassels
- Date: May 2004
- Competency: Communication>Persuasive communication; External Forces & Industry Knowledge>Internal forces and business performance; Technical Skills & Analytical Problem Solving
- Topics: Health & Disability>Health care; Public Policy
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Intimate Partner Violence: The Shadow Pandemic Part 2: Intimate Partner Violence During the COVID-19 Pandemic
see their family and friends or seek appropriate care. It is becoming clear that the forced quarantine ... stay-at-home orders. Essential services such as health care providers and police resources were stretched thin ...
- Date: Mar 2021
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health risks
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Letter from the Editor - Mary van der Heijde
information about specific programs like accountable care organizations (ACOs), as well as focused on the ... (and their members) have remained active in health care reform discussions. In June 2011, the Health Section ...- Authors: Mary Kindel Van der Heijde
- Date: Oct 2011
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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A Look At Community Rating
increasing access and affordability of medical care. Should older or high-risk individuals (or employers ... using pure community rat- ing at a time when health care costs were much lower. As the market became more ...- Authors: Alice Rosenblatt
- Date: Jun 1993
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context
- Publication Name: The Actuary Magazine
- Topics: Health & Disability>Health care
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Medigap: One Part of a Quest for a Fantastic Healthcare Future
Medigap: One Part of a Quest for a Fantastic Health Care Future By Jing Lang and Rajiv Sood Before I moved ... from Toronto, I was warned by many that the health care system in the U.S. is different; while it delivers ...- Authors: Rajiv Sood
- Date: May 2019
- Competency: External Forces & Industry Knowledge
- Publication Name: News Direct
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks
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Letter from the Editor
and their families, all the players in the health care mar- ket because of increased costs, across all ... have gained health care coverage due to Medicaid expansion under the Affordable Care Act (ACA). In the ...- Authors: JoAnn Bogolin
- Date: Oct 2018
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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Calibrating Risk Score Model with Partial Credibility
Risk adjustment models are commonly used in managed care programs to ensure that participating health plans ... commercial population. However, the variety of managed care populations (and benefits) is much larger than the ...
- Authors: Sheamus Parkes, Brad Armstrong
- Date: Oct 2015
- Competency: Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Expanding Horizons
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks; Modeling & Statistical Methods>Bayesian methods; Modeling & Statistical Methods>Data mining; Modeling & Statistical Methods>Estimation methods; Predictive Analytics