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The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries
The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries Explanation ... Financial planning; Health care reform; Health insurance; Health policy; Managed care; 4294991587 5/1/2012 ...- Authors: Adrian L Clark, Gabriela Dieguez, Bradley James Piper
- Date: May 2012
- Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy
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Medicare Advantage Hierarchical Condition Categories: Updated Study Results
Medicare Advantage Hierarchical Condition Categories: Updated Study Results Summary and analysis of ... Advantage population Medicare;Risk adjustment;Health care reform 4294993961 1/1/2013 12:00:00 AM ...- Authors: Corey Berger, Eric P Goetsch
- Date: Jan 2013
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks; Social Insurance>Medicare
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Health Watch, Issue 79, December 2015, Health Watch
teeism;Absenteeism;Smoking and mortality;health care reform;actuarial standards of practice;Regression ... efficiency;Product development;Health risks;Health care costs;marketing and distribution 6442465062 12/1/2015 ...- Authors: Society of Actuaries
- Date: Dec 2015
- Competency: Communication>Written communication; External Forces & Industry Knowledge; Leadership>Influence; Professional Values>Ethical standards; Relationship Management>Team leadership; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Experience Studies & Data>Disability; Health & Disability>Critical illness insurance; Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks; Modeling & Statistical Methods>Modeling efficiency; Modeling & Statistical Methods>Regression analysis; Technology & Applications>Computer science
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Validating a Novel Health Insurance Fraud Detection Method
Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies ... Health care fraud;Predictive modeling;Medicare;Health insurance;Health economics;Health care costs;Data ...- Authors: Robert D Lieberthal, Elias
- Date: Aug 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Economics>Health economics; Enterprise Risk Management; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Data mining; Predictive Analytics
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Harvard Researchers Join Actuaries In Risk Adjusters Study
Harvard Researchers Join Actuaries In Risk Adjusters Study The Society of Actuaries to fund a research ... proposal to investigate risk adjusters. Health care reform;Risk adjustment; 13165 11/1/1994 12:00:00 ...- Authors: Thomas Edwalds
- Date: Nov 1994
- Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: The Actuary Magazine
- Topics: Public Policy
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Rethinking Family Tiers
Rethinking Family Tiers A closer look at family tier factor rating assumptions, and how well they reflect ... claim cost data. Assumptions;Family coverage;Health care costs; 25712 1/1/2011 12:00:00 AM ...- Authors: Kristi Bohn
- Date: Jan 2011
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Modeling & Statistical Methods>Data mining; Technology & Applications>Analytics and informatics
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Proposed Regulations Refine "Net Premiums Written"
Proposed Regulations Refine "Net Premiums Written" Provides a summary ... health insurer fee, section 9010 of the Affordable Care Act (ACA). taxes;premiums;health insurance 6442476845 ...- Authors: Jean Baxley
- Date: Jun 2017
- Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Taxing Times
- Topics: Health & Disability>Health insurance
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Pricing Issues Resulting from Budget Setting and Stoploss in ACO Arrangements
Pricing Issues Resulting from Budget Setting and Stoploss in ACO Arrangements This article ... ;; Health care reform; Health reinsurance; Budgets; Stop-loss insurance; Accountable care organizations=ACO ...- Authors: Anthony Rubiano
- Date: May 2012
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks; Health & Disability>Payment models; Public Policy
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Pricing Issues Related to Supplemental Health Products
review;Coinsurance;Credibility theory;Group health plans;Health care costs;Health insurance;Individual health plans;Loss ... distribution;Medical expenses;Persistency;Preventive care;Product development;Underwriting;Third party administration=Third ...- Authors: Floyd Martin, Dennis Hare, Darrell D Spell
- Date: Jun 1999
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Accident insurance; Health & Disability>Critical illness insurance; Health & Disability>Health insurance; Reinsurance>Product development - Reinsurance
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Estimates of the Incidence, Prevalence, Duration, Intensity and Cost of Chronic Disability Among the U.S. Elderly
Estimates of the Incidence, Prevalence, Duration, Intensity and Cost of Chronic Disability ... September 2008 issue of Long-Term Care News. Chronic illness management;Health care costs;Life expectancy; 10019 ...- Authors: P J Stallard
- Date: Feb 2009
- Competency: Communication>Written communication; Professional Values>Public interest representation; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Long-Term Care News
- Topics: Actuarial Profession>Professional associations; Demography>Longevity; Experience Studies & Data>Disability; Long-term Care>Medical expenses; Modeling & Statistical Methods>Data mining; Modeling & Statistical Methods>Markov Chain