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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 ...

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    • 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
  • Industry Perspective Consumer Protection -Continuation of Benefits in Event of HMO Insolvency
    plan bene- fits for members confined in an acute care hospital on the date of insolvency until discharge ... magazine of NAMCR, the National Association of Managed Care Regulators, in late 1998. NAMCR was originally an ...

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    • Authors: Harry L Sutton
    • Date: Dec 2000
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance
  • The Role of the Actuary in Self-Insurance Released
    contribute to the self- insurance market for health care. Self- insurance is, arguably, the single most ... from early regulations through to the Affordable Care Act (ACA) • The differences between fully and self- ...

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    • Authors: John Mange, Hobson Carroll
    • Date: Jun 2018
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance
  • Actuarial and Underwriting Implications of the Final Health Privacy Rule
    present, or future payment for the provision of health care to an individual … and with respect to which there ... Supplement, Medicare+Choice, dental, or long-term care contract would be considered a “health plan,” and ...

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    • Authors: Rowen Bell
    • Date: Apr 2001
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
    • Publication Name: Health Watch
    • Topics: Public Policy
  • Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews
    The results are focused primarily on coordinated care plans (local HMOs, local PPOs and regional PPOs) ... Gender CHART 1 HCC Survey Results Coordinated Care Plan members (1) Includes All 70 HCCs (2) CHART ...

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    • Authors: Corey Berger, Eric P Goetsch
    • Date: Jan 2011
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving
    • Publication Name: Health Watch
    • Topics: Demography; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining; Social Insurance>Medicare; Technology & Applications>Analytics and informatics
  • 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
  • Will MedSupp Have “2020” Vision in the World of MACRA?
    Recently passed legislation referred to as MACRA (Medi-care Access and CHIP Reauthorization Act of 20151) will ... modeling various reasonable scenarios of the Medi- care Supplement market, experience on policies issued ...

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    • Authors: Kenneth Clark
    • Date: Mar 2017
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance