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Session 169: Risk Adjustment in Medicaid: Recent Developments
Consulting Group in 2012 • Principal in Denver Office – Primary focus on Government Programs with emphasis on ... allocate capitated payments between contracted managed care organizations Source: ResDAC Medicaid Risk Adjustment ...- Authors: Edward M Mailander, Daniel Henry
- Date: Feb 2020
- Competency: Technical Skills & Analytical Problem Solving
- Topics: Health & Disability; Health & Disability>Payment models; Public Policy; Public Policy
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Medicare Risk Contracts
community rate (ACR) filing process with the Health Care Financing Administration (HCFA). MEDICARE RISK ... allowed HMOs to contract with HCFA to provide health care coverage to Medicare beneficiaries on either a cost ...- Authors: Frank R Kopenski, Kenneth E Leinbach
- Date: Jun 1996
- Competency: External Forces & Industry Knowledge; Professional Values>Practice expertise
- Publication Name: Record of the Society of Actuaries
- Topics: Public Policy; Social Insurance>Medicare
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Back to the Future with Medicare: What Lies Ahead?
associate administrator for management at the Health Care Financing Administration (HCFA). He has been the ... Benefits Inpatient hospital care Physician services Skilled nursing care Outpatient hospital services ...- Authors: Application Administrator, Richard Foster, Roland E King, Joseph Antos, Robert Lynch
- Date: Jun 1996
- Competency: External Forces & Industry Knowledge
- Publication Name: Record of the Society of Actuaries
- Topics: Public Policy; Social Insurance>Medicare
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Prescription Drug Update
major driver of the return to double digit medical care premium increases and renewed interest in Congress ... joining AdvancePCS, Amy worked in managed health care managing actuarial analysis for both commercial ...- Authors: Bryan Miller, Gordon R Trapnell, Amy Ann Companik
- Date: Oct 2000
- Competency: Strategic Insight and Integration>Management partnership; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health insurance; Public Policy
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AHPs: Are Association Health Plans a Remedy or a Pending Disaster?
development on Medicare, insurance reform and managed care legislation. I'm Jim O'Connor. I'm a consulting ... talk about why associations are important to health care. I'll also talk a little about the legislation ...- Authors: James O'Connor, Kris Haltmeyer, Donald G Dressler
- Date: May 2004
- Competency: Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health insurance; Public Policy
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Sickness and Accident
normal living expenses but cannot cover their medical care. Perhaps an extension of this type of provision ... hospitals have specialized in chronic diseases and care of the aged more than nongovernmental institutions ...- Authors: Society of Actuaries, James F Coleman, John C Maynard, George N Watson, Manuel Gelles, Ralph H. Maglathlin, Herbert J. Stark, Henry S Beers
- Date: Oct 1953
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Transactions of the SOA
- Topics: Health & Disability>Disability insurance; Health & Disability>Health insurance; Public Policy; Public Policy; Social Insurance>Government-funded healthcare
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The Future of Individual and Small Group Medical Insurance
give you a good idea if you are purchasing health care at the right price, doing cost containment appropriately ... I think the more fundamental issue with health care purchasing is to recognize that it's very different ...- Authors: Application Administrator, James Oatman, Jerome Winkelstein
- Date: Jun 2003
- Competency: External Forces & Industry Knowledge
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health insurance; Public Policy
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Long Term Disability Insurance
conditions, changing work ethics, and improving health care. There should be separate tables by sex, LONG ... strictly through the individual contract. The primary problem with such a solution is that benefits would ...- Authors: John C Angle, W Duane Kidwell, William J Taylor
- Date: May 1977
- Competency: Communication>Oral communication; External Forces & Industry Knowledge>External forces and business performance; Strategic Insight and Integration
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Disability insurance; Public Policy; Social Insurance
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Influencing Health Policy: Efforts and Impacts of the American Academy of Actuaries
uninsured, health care affordability, consumer-driven health care and long-term care. MR. GEOFFREY ... Milliman, and she has more than 20 years of health care expertise. She's consulted with health plans on ...- Authors: Geoffrey C Sandler, Janet Carstens, Cori Uccello, Craig Hanna
- Date: May 2004
- Competency: Communication>Persuasive communication
- Publication Name: Record of the Society of Actuaries
- Topics: Actuarial Profession>Academic partnerships; Actuarial Profession>Professional associations; Public Policy
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Pandemic Influenza Preparedness in the Financial Services Sector
Pandemic Influenza Preparedness in the Financial Services Sector Statement of the American Council ... threat of pandemic influenza. ACLI is the primary trade association for life insurers in the United ...- Authors: Robert K Gleeson
- Date: Jun 2006
- Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Public interest representation
- Topics: Health & Disability>Health risks; Public Policy