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  • Human Nature and the US Health Care System, Part I
    strategic interactions of those who participate in the U.S. health care system, understand the root causes of ... confuse them—Harry Truman What is the problem with the U.S. health care system? Answering this question is important ...
    • Authors: Carlos Eduardo Fuentes
    • Date: Feb 2018
    • Competency: External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>General business skills; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Innovators & Entrepreneurs
    • Topics: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health insurance
  • Medicare Advantage Star Ratings: Expectations for New Organizations
    Ratings: Expectations for New Organizations By Kelly S. Backes, Julia M. Friedman, Dustin J. Grzeskowiak ... Advantage Bid Rebate Federal Part C Revenue Table 1 2019 Quality Bonus Payment and Rebate Percentages ...

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    • Authors: Kelly Backes, Julia Friedman, Dustin Grzeskowiak, Elizabeth Phillips, Patricia Zenner
    • Date: Jun 2018
    • Competency: External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>Internal forces and business performance; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health insurance; Social Insurance>Medicare
  • Considerations for Surplus Determination under ACA
    There are five separate actionable outcomes (see Table 1). For a health care insurer that is between 200 ... He can be reached at richard.tash@optum. com Table 1: Risk-Based Capital authoritative action Outcomes ...

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    • Authors: Daniel Pribe, Richard Tash, David M Tuomala
    • Date: May 2014
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health insurance; Public Policy
  • The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries
    payment percentages by star rat- ing are shown in the table in Figure 1. The percentage of the savings a plan ... rebate percentages by star rating are shown in the table in Figure 2. Special rules apply to low-enrollment ...

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    • Authors: Adrian L Clark, Gabriela Dieguez, Bradley James Piper
    • Date: May 2012
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy
  • Selling Health Insurance Across State Lines
    implementation of the ACA. The ACA allows the U.S. Office of Personnel Management (OPM) to oversee ... of America, the District of Colum- bia and the U.S. Territories. 2 From Kaiser Health News: State coverage ...

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    • Authors: Lawrence Mitchell
    • Date: Aug 2017
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Influence decisions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: In The Public Interest
    • Topics: Health & Disability>Health insurance; Public Policy