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Session 095: Drug Claim Management - Lessons from Canada
Canada The presenters will focus on best practices in drug claim management in North America. The presentation ... and insights, but is useful for practitioners in the U.S. and elsewhere, as well. Health & Disability ...- Authors: Daniel Berty, Martin Chung, Erin Crump, Ned Pojskic
- Date: Feb 2020
- Competency: Results-Oriented Solutions
- Topics: Health & Disability; Health & Disability>Chronic health management - Health & Disability; Health & Disability>Payment models
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2022-competitive-con-aca
As the ACA market evolves with changing regulatory and competitive landscape, the evaluation of risk ...- Authors: Patrick P Ryan, Brent Jensen, Brian J Perlman, Sara Hemmingson
- Date: Sep 2022
- Competency: Results-Oriented Solutions
- Topics: Health & Disability
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2023-collabo-cloud-combat
from Cleveland Clinic and Milliman discuss the development of a sepsis prediction model using machine learning ... unique challenge of handling massive amounts of data for near real-time risk scoring, the team took their ...- Authors: Michael Bromley, Joseph Michael Dorocak
- Date: May 2024
- Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Topics: Health & Disability; Modeling & Statistical Methods; Predictive Analytics
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2023-health-meeting-session-5e
patient leaving the hospital has personal life-context circumstances that impact their chances of successful ... percent of health care spend, with the admitted commercial population driving 37 percent of spend or ...- Authors: Society of Actuaries
- Date: Jan 2024
- Competency: Results-Oriented Solutions
- Topics: Experience Studies & Data; Health & Disability; Technology & Applications
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A Patient Centric Approach to AI in Health Insurance
Patient Centric Approach to AI in Health Insurance The article explores how integrating AI into insurer ... non-disruptive approaches aim to increase the effectiveness of patient interventions and improve medication ...- Authors: Scott Damery
- Date: May 2024
- Competency: Results-Oriented Solutions
- Topics: Health & Disability; Health & Disability>Health insurance; Technology & Applications; Technology & Applications>Artificial intelligence & machine learning
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New Contract Medicare Star Ratings: Why The Sudden Cliff?
New Contract Medicare Star Ratings: Why The Sudden Cliff? On average, contracts receiving their first ... decreases their payments in the following calendar year. This article explores the disparity in Medicare Advantage ...- Authors: Suzanna-Grace Sayre, Danielle Beierle
- Date: Jan 2020
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance
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Session 1A: Upgrading and Development of Health Management and Health Insurance
1A: Upgrading and Development of Health Management and Health Insurance The prospects for China's health ... incentivized by a series of favorable government policies to support the development of commercial health insurance ...- Authors: Yan Yang
- Date: Jul 2019
- Competency: Communication; External Forces & Industry Knowledge; Leadership; Professional Values; Relationship Management; Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Topics: Health & Disability
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2023-health-meeting-session-9d
measuring value. The discussion will cover different structures currently in use, types of services covered ... covered (total cost of care, claim service lines, specialties, condition based, pharmacy products, etc.) ...- Authors: Society of Actuaries
- Date: Jan 2024
- Competency: Results-Oriented Solutions
- Topics: Health & Disability
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role-social-determinants
Medicare and Medicaid to address Social Determinants of Health (SDOH). Employers can learn from these models ... can understand and address SDOH, the incentives for doing so, and the broader benefits. 26252 1018 ...- Authors: Leticia Harris, Shelley Joan Moss, Sara Teppema
- Date: May 2024
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration
- Topics: Actuarial Profession; Demography; Health & Disability
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2024-supp-health-di-ltc
The Supplemental Health, DI & LTC Conference provides a unique opportunity to consider a cross-functional ... cross-functional view of supplemental health products, individual disability insurance, and long-term care standalone ...- Date: Dec 2023
- Competency: External Forces & Industry Knowledge; Professional Values; Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Topics: Health & Disability; Long-term Care