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  • Possible Future of U.S. Healthcare
    Possible Future of U.S. Healthcare What is the difference between a Single-Payer and Universal Health ... System, and how could the U.S. implement a system that would reduce the growth of medical costs while increasing ...

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    • Authors: Roy Goldman
    • Date: Nov 2019
    • Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
    • Publication Name: Health Watch
    • Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
  • Provider Risk-Sharing and Random Noise
    Provider Risk-Sharing and Random Noise ... Discussion and Opinion on how randomness affects measurement of provider contracting risk-sharing agreements ...

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    • Authors: Thomas Messer
    • Date: Jul 2019
    • Competency: External Forces & Industry Knowledge; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Payment models; Health & Disability>Provider networks; Health & Disability>Provider risk
  • Examining the Evidence - Enhanced Primary Care Leads to Reduced Hospital Use and Saves Costs - Or Does It?
    Examining the Evidence - Enhanced Primary Care Leads to Reduced Hospital Use and Saves Costs - Or Does ... savings have been achieved. Patient-centered medical homes;Payment models;Payment reforms;Managed care ...

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    • Authors: Tia Sawhney, Bruce Pyenson
    • Date: Jan 2015
    • Competency: External Forces & Industry Knowledge
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health risks; Health & Disability>Payment models
  • Our Value-Based Cup Runneth Over
    Our Value-Based Cup Runneth Over Discussion of how to mature value-based contracts between health insurers ... actuaries and leaders. Authors are writing from the provider perspective in value-based contracts. th ...

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    • Authors: Daniel Reck (Dan), Lisa Swan, Sam Johnmeyer
    • Date: Aug 2022
    • Competency: Communication; External Forces & Industry Knowledge; Strategic Insight and Integration
    • Publication Name: Health Watch
    • Topics: Enterprise Risk Management>Risk appetite; Enterprise Risk Management>Risk measurement - ERM; Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models; Health & Disability>Provider risk
  • A Comparison Between the ACA Exchange and Medicare Risk Adjustment Programs
    A Comparison Between the ACA Exchange and Medicare Risk Adjustment Programs Risk adjustment ... Between the ACA Exchange and Medicare Risk Adjustment Programs Risk adjustment is used to adjust the revenue ...

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    • Authors: Kurt Wrobel
    • Date: Jan 2015
    • Competency: External Forces & Industry Knowledge
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Social Insurance>Medicare
  • The Center for Health Care Strategy (CHCS)
    The Center for Health Care Strategy (CHCS) CHCS is a nonprofit policy center focused on improving American ...

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    • Authors: Society of Actuaries
    • Date: Jun 2017
    • Competency: External Forces & Industry Knowledge; Technical Skills & Analytical Problem Solving>Innovative solutions
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Payment models; Public Policy
  • Outpatient Facility Reimbursement
    Outpatient Facility Reimbursement Review of reimbursement methodologies APGs, APCs, Medicare ASC, discount ...

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    • Authors: Brian Small
    • Date: Oct 2002
    • Competency: External Forces & Industry Knowledge
    • Publication Name: Health Watch
    • Topics: Health & Disability>Payment models
  • Can Direct-to-Provider Contracting Achieve Value-Based Care for Employer-Sponsored Plans?
    provider of healthcare services rather than through a third-party administrator (TPA), often with the goal ... goal of driving value-based care. This article discusses the considerations for employers and providers ...

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    • Authors: Andrew James Timcheck, Cory Gusland, Michael Gaal
    • Date: Dec 2019
    • Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
    • Publication Name: Health Watch
    • Topics: Health & Disability; Health & Disability>Payment models