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Effective Contracting with Pharmacy Benefit Managers: Protecting a plan sponsor’s resources
Effective Contracting with Pharmacy Benefit Managers: Protecting a plan sponsor’s resources A discussion of issues to consider in selecting and contracting with a PBM. Audits;Payment ...- Authors: Robert Gordon Cosway, Brian Anderson
- Date: Feb 2010
- Competency: Communication; Relationship Management>Relationships and trust
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health care quality
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New Assessment Program for PPOs
New Assessment Program for PPOs New NCQA Quality Assessment Program for PPOs discussing rationale and performance meansurements, Issue No. 38. Preferred provider organization=PPO; 9372 8/1/2000 ...- Authors: Louis Lana
- Date: Aug 2000
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Health & Disability>Health care quality
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Frequently Asked Questions about the Cost of the Future Newly Insured under the Affordable Care Act (ACA) SOA Study--And Other Things you Migh Not Know by Just Reading the Executive Summary
Frequently Asked Questions about the Cost of the Future Newly Insured under the Affordable Care Act (ACA) SOA Study--And Other Things you Migh Not Know by Just Reading the Executive Summary Recap ...- Authors: David Toumala
- Date: Oct 2013
- Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health care quality; Health & Disability>Health insurance; Public Policy
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Provider Risk-Sharing and Random Noise
Provider Risk-Sharing and Random Noise Discussion and Opinion on how randomness affects measurement of provider contracting risk-sharing agreements 7/3/2019 12:00:00 AM ...- 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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Valuation of Care Management Vendors
Valuation of Care Management Vendors Methods and assumptions used in the valuation of savings by external care vendors 5/1/2020 12:00:00 AM ...- Authors: Rick S Pawelski
- Date: May 2020
- Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
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Bundled Reimbursement: A Step in the Right Direction, or Another Flawed Idea?
Bundled Reimbursement: A Step in the Right Direction, or Another Flawed Idea? An overview of the issues behind reimbursing providers on a bundled or packaged basis. The article presents the ...- Authors: Todd Lueders
- Date: Sep 2010
- Competency: External Forces & Industry Knowledge; Professional Values>Public interest representation; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health care quality; Public Policy; Public Policy
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Medicaid Encounter Data: The Next National Data Set
Medicaid Encounter Data: The Next National Data Set Summary of Medicaid encounter data, including how it is collected by health plans, transferred to state databases, used by states, and ...- Authors: Jennifer Gerstorff, Sabrina Gibson
- Date: Sep 2016
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Internal forces and business performance
- Publication Name: In The Public Interest
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Public financing - Health & Disability
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Actuarial Aspects of Alternative Care
Actuarial Aspects of Alternative Care Presenter discusses issues related to alternative care, as well as SOA activity in regard to alternative care. From the Record of the Society of Actuaries, ...- Authors: Lee Eric Launer
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Big picture view
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health care quality
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Health Care Reform Around the World
Health Care Reform Around the World Panelists discuss major reforms of health care financing and delivery systems around the world. From the Record of the Society of Actuaries, Vol. 24, No. 2.- Authors: Chiu-Cheng Chang, Lawrence Miike, Joshua Bank
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Public Policy
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Globalization of the Pharmaceutical Supply Chain: What are the Risks? The FDA’s Difficult Task
Globalization of the Pharmaceutical Supply Chain: What are the Risks? The FDA’s Difficult Task This article talks about the challenges facing the FDA, especially those arising from the ...- Authors: Jill Van Den Bos
- Date: May 2009
- Competency: External Forces & Industry Knowledge; Professional Values>Public interest representation; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Health & Disability>Health care quality; Public Policy; Technology & Applications