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Palliative Care
Palliative Care This article from major US ... payers describes palliative care as a scaleable means of improving quality and reducing costs during serious ...- Authors: Randall Krakauer, Bruce Smith, Diane Meier, Torrie Fields
- Date: Nov 2016
- Competency: Leadership>Change management; Leadership>Influence; Leadership>Mentoring; Leadership>Professional network leverage; Leadership>Thought leadership; Results-Oriented Solutions>Actionable recommendations; Results-Oriented Solutions>Assess decision effectiveness; Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Effective decision-making
- Publication Name: Health Watch
- Topics: Economics>Health economics; Enterprise Risk Management>Systematic risk; Experience Studies & Data>Morbidity; Experience Studies & Data>Mortality; Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care quality; Health & Disability>Payment models
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Escaping the Addiction – From Preferred Payer to Rational Pricing
Escaping the Addiction – From Preferred Payer to Rational Pricing A proposal to reform current health ... system, in which Medicare and Medicaid pay less than the true cost while others must then pay more, to a 'value ...- Authors: Hobson Carroll
- Date: Sep 2010
- Competency: Leadership>Thought leadership; Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability; Public Policy; Public Policy; Social Insurance>Medicaid; Social Insurance>Medicare
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Providers: Reorganize and Refinance
rethinking of current provider reimbursement, focusing on incentives instead of simply cutting fees. The recommended ... evidence-based decision making organized around episodes of care. Accountable care organizations= ACO;Episode-based ...- Authors: Jill Van Den Bos
- Date: Sep 2010
- Competency: Leadership>Thought leadership; Results-Oriented Solutions>Assess decision effectiveness; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health care quality; Health & Disability>Payment models; Public Policy
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Massachusetts Payment Reform from an Actuarial Perspective
Perspective The article is a case study of various actuarial concepts invovled in the design and implementtion ... implementtion of the AQC - a global budget provider payment arrangement implemented by Blue Cross Blue ...- Authors: Matthew Day, Jill Wilson
- Date: May 2013
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Payment models; Public Policy
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Medicare Advantage risk scores – Are you competitive?
Medicare Advantage risk scores – Are you competitive? What you need to know about ... need to know about risk scores to be competitive in the Medicare Advantage market. Medicare;Risk adjustment;Health ...- Authors: Corey Berger
- Date: Oct 2018
- Competency: Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Social Insurance>Medicare
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Value Based and Accountable Care: The Actuarial and Clinical Role in Building a Sustainable Model
Value Based and Accountable Care: The Actuarial and Clinical Role in Building a Sustainable Model As ... model into the future. This requires actuarial and clinical/provider capabilities to assess the care management ...- Authors: Mark Bethke, James M Whisler, Amanda Holland
- Date: May 2013
- Competency: Leadership>Change management; Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Payment models; Modeling & Statistical Methods>Forecasting; Modeling & Statistical Methods>Sensitivity testing; Modeling & Statistical Methods>Value at risk - Modeling & Statistical Methods; Public Policy
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Why so Many People Have Untreated Mental Health Conditions
People Have Untreated Mental Health Conditions The article reviews high-deductible health plans and ... mental health providers as being the root of 3 devastating problems facing the US. Mental health care;Chronic ...- Authors: Dawn Motovidlak
- Date: Jun 2018
- Competency: Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models