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Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews
Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews Identifying ... payments to Medicare Advantage plans. Milliman's HCC prevalence study illustrates the significant variations ...- Authors: Corey Berger, Eric P Goetsch
- Date: Jan 2011
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Demography; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining; Social Insurance>Medicare; Technology & Applications>Analytics and informatics
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Assessing Prescription Opioid Risk with Predictive Analytics
National Vital Statistics System. Mortality. CDC Wonder, Atlanta: U.S. Department of Health and Human ... Tamara M. Haegerich, and Roger Chou. Morbidity and Mortality Weekly Report: CDC Guideline for Prescribing ...- Authors: Joseph Boschert, Andrew Gaffner, Barbara Collier
- Date: Oct 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making; Strategic Insight and Integration>Influence decisions; 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: Health Watch
- Topics: Demography>Population data; Experience Studies & Data; Health & Disability>Health information technology; Modeling & Statistical Methods>Data mining; Predictive Analytics; Technology & Applications>Analytics and informatics; Health & Disability>Electronic medical record
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Modeling Anti-selective Lapse and Optimal Pricing in Individual and Small Group Health Insurance
conditions that if =M, then L =1/2 and vice versa. S is an “s”-shaped monotonically increasing function with ... if z=1. A special case for S is a step function with S(z)=0 if z <1, S(z) =1 if z >1 and if z=1 (Figure ...- 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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Rethinking Family Tiers
Rethinking Family Tiers A closer look at family tier factor rating assumptions, and how well ... average adult costs would suggest. The follow- ing table shows the claims ratios we experienced, where we ...- Authors: Kristi Bohn
- Date: Jan 2011
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Modeling & Statistical Methods>Data mining; Technology & Applications>Analytics and informatics
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Getting Actuaries More Engaged in Population Health
Getting Actuaries More Engaged in Population Health Introduction to population health, a collaborative ... actuaries the opportunity to have a “seat at the table” when the programs are designed, and give actuaries ...- Authors: Robert D Lieberthal
- Date: Jan 2011
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Leadership>Thought leadership; Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Actuarial Profession>Alternative careers; Economics>Health economics; Health & Disability>Health care quality; Public Policy; Technology & Applications>Analytics and informatics
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Health Risk Assessments in a Protected Environment
Health Risk Assessments in a Protected Environment A discussion of permissible use and collection ... information. Recently, three federal agen- cies, the U.S. Departments of Treasury, Labor, and Health and ...- Authors: John C Cameron
- Date: May 2010
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Professional Values>Ethical standards
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks; Public Policy; Technology & Applications>Analytics and informatics