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What does ERM mean for Health Practitioners?
Practitioners? In this article, the author discusses the considerations and advantages of implementing an integrated ... health insurance company, and presents a summary of Aetna's experience with ERM as a case study.- Authors: Max Rudolph
- Date: Feb 2010
- Competency: External Forces & Industry Knowledge>External forces and business performance; Relationship Management>Staff management and motivation; Results-Oriented Solutions; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Economics>Health economics; Enterprise Risk Management; Modeling & Statistical Methods>Forecasting
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Validating a Novel Health Insurance Fraud Detection Method
Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies ... detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection ...- 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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Modeling Anti-selective Lapse and Optimal Pricing in Individual and Small Group Health Insurance
Rather than being assumed at the outset, lapse rates emerge from the model, along with assessment spiral ... ratio projections. Under the model optimal pricing strategy depends on whether the class being rated has ...- Authors: D Wei
- Date: Feb 2010
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health risks; Modeling & Statistical Methods; Technology & Applications>Analytics and informatics
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Avian Flu: Bracing for a Pandemic
Flu: Bracing for a Pandemic Discussion of the economics of a possible H5N1 pandemic, and its impact ... and Property and Casualty insurers, in terms of areas of risk, especially underwritng risk, operations ...- Authors: Darrell Knapp
- Date: Jul 2006
- Competency: External Forces & Industry Knowledge>External forces and business performance; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Topics: Economics>Health economics; Enterprise Risk Management>Capital management - ERM; Enterprise Risk Management>Operational risks; Life Insurance>Underwriting - Life Insurance