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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 ... providers are considering accountable and value based care models, it is critical to strategically think through ...

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    • 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
  • Massachusetts Payment Reform from an Actuarial Perspective
    implemented by Blue Cross Blue Shield of MA. Accountable Care Organizations=ACO;Health Maintenance Organization=HMO;Health ... Organization=HMO;Health Policy;Payment Models=Health Care Payment Models 6442450977 5/1/2013 12:00:00 AM ...

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    • 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
  • Medicare Advantage risk scores – Are you competitive?
    status of their populations continues to be a primary key to their success. This article updates those ... member based on ICD- 10 diagnosis codes from health care claims. A member is assigned an HCC if an ICD- 10 ...

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    • 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