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Using Predictive Modeling to Risk-Adjust Primary Care Panel
Using Predictive Modeling to Risk-Adjust Primary Care Panel This article discusses techniques used to create risk scores to help determine appropriate primary care panel sizes for a provider ...- Authors: Anders Larson
- Date: Jun 2017
- Competency: Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Predictive Analytics and Futurism Newsletter
- Topics: Health & Disability>Payment models; Predictive Analytics
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At the Intersection of Public Health and Actuarial Practice
At the Intersection of Public Health and Actuarial Practice An edited written interview with two actuaries and a public health professional on issues related to the intersection between the two ...- Authors: Barbara Zabielski
- Date: Oct 2017
- Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Public interest representation
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional associations; Health & Disability>Health care; Health & Disability>Payment models; Public Policy; Social Insurance>Medicaid
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Session 044: Transitioning a Health System from Separate Physician and Hospital Reimbursement to Global Payment
Session 044: Transitioning a Health System from Separate Physician and Hospital Reimbursement to Global Payment This is a case study session where the speakers will describe a project where a ...- Authors: David Axene, Elaine Corrough, Stephanie Dawn Entzminger
- Date: May 2019
- Competency: Strategic Insight and Integration
- Topics: Health & Disability>Payment models; Predictive Analytics
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Session 023: A Common Vision of Value-Based Care: Case studies of Payer-Provider Collaboration
Session 023: A Common Vision of Value-Based Care: Case studies of Payer-Provider Collaboration In the current value-based care marketplace, there are various reimbursement models that tie ...- Authors: David Hanekom, Maureen B Tresnak , Fan Zhang
- Date: May 2019
- Competency: Strategic Insight and Integration
- Topics: Health & Disability>Health care quality; Health & Disability>Payment models
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Session 031: Pharmacy Pricing - US Policy and Global Perspective
Session 031: Pharmacy Pricing - US Policy and Global Perspective US pharmacy prices have entered a new era of growth driven by Specialty medications. A bevy of state and national regulations ...- Authors: Gregory L Warren, Laura Elizabeth Coe , Scott Fry
- Date: May 2019
- Competency: External Forces & Industry Knowledge
- Topics: Health & Disability>Payment models; Public Policy
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Yi-Ling Lin: SOA Predictive Analytics Program Prepares You for Health Care’s Future
Yi-Ling Lin: SOA Predictive Analytics Program Prepares You for Health Care’s Future Yi-Ling Lin, FSA, MAAA, FCA, started the SOA’s Predictive Analytics Certificate Program to keep pace with the ...- Authors: Society of Actuaries
- Date: Nov 2019
- Topics: Health & Disability; Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Predictive Analytics; Health & Disability>Affordable Care Act (ACA); Health & Disability>Association Health Plans; Health & Disability>Claims - Health & Disability; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques; Predictive Analytics>Programming languages & tools; Health & Disability>Electronic medical record
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Direct Primary Care: Good for What Ails Us
Direct Primary Care: Good for What Ails Us Discussion of direct primary care and how it helps with several challenges in health care today. DPC improves care coordination, improves outcomes, ...- Authors: Gayle Brekke
- Date: May 2016
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Leadership>Thought leadership; Professional Values>Public interest representation; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health insurance; Health & Disability>Payment models
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Provider Risk Sharing Boot Camp for Health Actuaries
Provider Risk Sharing Boot Camp for Health Actuaries Changes introduced by various Medicare Alternative Payment Models and the Medicare Access and CHIP Reauthorization Act (MACRA) have ...- Authors: Colleen Audrey Norris
- Date: Nov 2018
- Competency: External Forces & Industry Knowledge; Professional Values; Technical Skills & Analytical Problem Solving
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Social Insurance>Medicare
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Session 186: Evolving Value Based Programs and the Impacts on Provider Analytics & Reporting
Session 186: Evolving Value Based Programs and the Impacts on Provider Analytics & Reporting As value-based solutions evolve, it is more important than ever for providers to understand their ...- Authors: Patrick Jason Colbert, Jeremiah Reuter, Joshua McPhee
- Date: Mar 2020
- Competency: External Forces & Industry Knowledge
- Topics: Health & Disability; Health & Disability>Payment models
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Session 095: Drug Claim Management - Lessons from Canada
Session 095: Drug Claim Management - Lessons from Canada The presenters will focus on best practices in drug claim management in North America. The presentation is geared toward Canadian practice ...- 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