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  • Pricing Issues Resulting from Budget Setting and Stoploss in ACO Arrangements
    ACO budgeting and pricing of stoploss coverage, including: 1) attribution of members; 2) claim carve outs; ... stoploss terms; 4) providers gaming the system and 5) credibility of data. ;; Health care reform; Health ...

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    • 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
  • Commercial Health Care: What’s Next?
    Commercial Health Care: What’s Next? This article contains a ... condensed summary and excerpt from the fourth white paper in the Commercial Health Care: What’s Next ...

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    • Authors: David Dillon
    • Date: Feb 2018
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; Leadership>Thought leadership
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health risks; Public Policy; Public Policy