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  • Commercial Healthcare: What's Next
    Commercial Healthcare: What's Next A new initiative, Commercial Health ... Commercial Healthcare: What's Next A new initiative, Commercial Health Care: What’s Next, will focus on education ...

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    • Authors: David Dillon, Elaine Corrough
    • Date: Jun 2017
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Practice expertise; Strategic Insight and Integration>Big picture view
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health insurance; Public Policy; 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? series. health care reform;risk adjustment;health ...

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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
  • Commercial Health Care: What’s Next? A Health Section Strategic Initiative
    Health Care: What’s Next? A Health Section Strategic Initiative The Health Section's strategic initiative ... initiative entitled Commercial Health Care: What’s Next? focuses on health care reform. This article contains ...

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    • Authors: David Dillon
    • Date: Oct 2018
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Public Policy; Public Policy
  • Medicare Advantage—Future Benchmarks
    Medicare Advantage—Future Benchmarks This article discusses future benchmarks ... discusses future benchmarks of Medicare and Medicare's rising costs and its relativity to the actuarial profession ...

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    • Authors: Application Administrator
    • Date: May 2008
    • Competency: External Forces & Industry Knowledge>External forces and business performance
    • Publication Name: Health Watch
    • Topics: Public Policy; Social Insurance>Medicare
  • The Evolution of the Individual Market (Part II)
    The Evolution of the Individual Market (Part II) Part II of a two-part series discussing ... evolution from before the ACA through President Trump's first term. Individual health plans, Government-funded ...

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    • Authors: Gregory Fann
    • Date: Mar 2019
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; Strategic Insight and Integration>Big picture view
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance; Public Policy; Public Policy
  • Medicare Advantage Part C Revenue: Challenges Ahead
    Medicare Advantage Part C Revenue: Challenges Ahead Analysis of the projected impact of the ... based on the Medicare Trustees report and author's assumptions. Patient Protection and Affordable Care ...

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    • Authors: Timothy Courtney
    • Date: Jan 2013
    • Competency: External Forces & Industry Knowledge>External forces and business performance
    • Publication Name: Health Watch
    • Topics: Public Policy
  • 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
  • Accountable Care Organizations: An Untapped Opportunity
    third-party, objective analysis when they are at the table bargain- 8 | september 2010 | Health Watch area ... health care costs if actuaries had been at the table with providers earlier in the process. ACO leadership ...

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    • Authors: Jim Toole, Sara Teppema
    • Date: Sep 2010
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Leadership>Thought leadership; Professional Values>Public interest representation; Strategic Insight and Integration
    • Publication Name: Health Watch
    • Topics: Enterprise Risk Management>Risk measurement - ERM; Enterprise Risk Management>Strategic risks; Health & Disability>Health care; 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