Description: This is the Health Section News, August 2005, Issue 50 and discusses accessing and using public data: A primer for the health actuary. Health data no longer is an afterthought but it is an essential component of health care delivery, payment and decisions.

Description: Recent health care reform activity has highlighted the importance of Clinical Integration in improving the quality, safety, efficiency and reimbursement infrastructure of the health care system. This article discusses relevance and implication of regulatory measures, implementation and data issues, and provides an end-to-end example.

Description: We highlight a new approach leveraging predictive analytics to identify high risk and rising risk opioid users for more effective screening and follow-up care.

Description: The purpose of this paper is to define a predictive model, based on known system attributes, for assessing risk associated with information systems.

Description: Impact of Technology on Health Care Delivery Systems - Chart 3

Description: The panelists address Health Insurance Portability and Accountabuility Act [HIPAA] related concerns for health insurers, such as: implementation issues, privacy, transactions and code sets, employer identification numbers, and current developments relative to the pending rules. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 65

Description: Medicare Advantage Organizations must consider influences both internal and external to the adjudication process as they review and use data for bid preparation

Description: Essays show a new system that will encompass minor changes to the current health insurance system, it will allow consumers to sign up for Federal Employees Health Benefit Plan and be administered like Medicare but with more benefits and emphasis on preventive care.

Description: This article describes and, more importantly, identifies information systems which are either in existence or planned on the national, state, and local levels. It describes the data available on the national level from the National Center for Health Statistics, the 05ce of Research and Statistics of the Social Security Administration, the AMA, the AHA, etc. It also describes a number of state and local information systems and addresses itself to information systems for inpatient care, ambulatory care, and the needs and likely sources of data for PSRO’s.

Description: A Regulatory Perspective on Rate Review Before and After the Affordable Care Act