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  • Can Direct-to-Provider Contracting Achieve Value-Based Care for Employer-Sponsored Plans?
    Can Direct-to-Provider Contracting Achieve Value-Based Care for Employer-Sponsored Plans? Can Direct-to-Provider ... Contracting Achieve Value-Based Care for Employer-Sponsored Plans? Direct-to-provider contracting is a strategy ...

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    • Authors: Andrew James Timcheck, Cory Gusland, Michael Gaal
    • Date: Dec 2019
    • Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
    • Publication Name: Health Watch
    • Topics: Health & Disability; Health & Disability>Payment models
  • 073 - Employer to Provider Direct Contracting - What's The Big Deal?
    073 - Employer to Provider Direct Contracting - What's The Big Deal? This session will provide information ... provider direct contracting. We will discuss the number and types of the most prevalent direct contracts ...

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    • Authors: Kevin Dotson, Robert Joseph Nation, James Patrick Hazelrigs
    • Date: Jul 2019
    • Competency: Strategic Insight and Integration
    • Topics: Health & Disability>Health insurance; Health & Disability>Payment models
  • Session 023: A Common Vision of Value-Based Care: Case studies of Payer-Provider Collaboration
    Value-Based Care: Case studies of Payer-Provider Collaboration In the current value-based care marketplace ... reimbursement models that tie payments for care delivery to the quality of the care provided. The purpose is clear ...

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    • Authors: David Hanekom, Maureen B Tresnak , Fan Zhang
    • Date: May 2019
    • Competency: Strategic Insight and Integration
    • Topics: Health & Disability>Health care quality; Health & Disability>Payment models
  • 105 - Reinsurance Considerations for Providers Participating in Value Based Contracts
    105 - Reinsurance Considerations for Providers Participating in Value Based Contracts With ... and payers. Stop-loss insurance; Accountable care organizations= ACO; Catastrophic risk; Health reinsurance; ...

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    • Authors: Annie Man, Jeremiah Reuter
    • Date: Jul 2019
    • Competency: Strategic Insight and Integration
    • Topics: Health & Disability>Payment models; Reinsurance>Stop-loss insurance
  • Possible Future of U.S. Healthcare
    difference between a Single-Payer and Universal Health Care System, and how could the U.S. implement a system ... quality. Medicare for All, Payment reforms=Health care payment reforms 11/22/2019 12:00:00 AM ...

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    • Authors: Roy Goldman
    • Date: Nov 2019
    • Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
    • Publication Name: Health Watch
    • Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
  • Session 124PD: Risk-Adjustment and Related Issues in Episode-Based Payments
    actuaries love acronyms  ACH – Acute care hospital  ACO – Accountable Care Organization  AMI – Acute Myocardial ... Bundled Payments for Care Improvement Model  BPCI Advanced – Bundled Payments for Care Improvement Advanced ...

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    • Authors: Thomas Snook, Kathryn Elizabeth Rains-McNally, Lili Brillstein, Samuel Bennett
    • Date: Oct 2018
    • Competency: Strategic Insight and Integration
    • Topics: Health & Disability>Payment models; Public Policy
  • Session 044: Transitioning a Health System from Separate Physician and Hospital Reimbursement to Global Payment
    closely follow federal law. The Sherman Act, is the primary U.S. antitrust law pertaining to association activities ... academic medical center • two separate community acute care health systems • related IPAs and medical groups ...

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    • Authors: David Axene, Elaine Corrough, Stephanie Dawn Entzminger
    • Date: May 2019
    • Competency: Strategic Insight and Integration
    • Topics: Health & Disability>Payment models; Predictive Analytics
  • Provider Risk-Sharing and Random Noise
    infrastructure. Pricing actuaries will need to estimate the direct effect of random fluctuations, the indirect effect ... Some- times Shi– Accountability to HMOs. Managed Care, Dec. 1, 2000. https://www .managedcaremag.com ...

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    • Authors: Thomas Messer
    • Date: Jul 2019
    • Competency: External Forces & Industry Knowledge; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Payment models; Health & Disability>Provider networks; Health & Disability>Provider risk
  • Is Your Integrated Delivery System Throwing Away Free Money?
    of both the delivery and the insur-ing of health care should be powerful. That is the theory behind an ... explain why. Optimizing value in an integrated health care delivery system requires aligning the financial ...

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    • Authors: Karan Rustagi
    • Date: Feb 2018
    • Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
    • Publication Name: Health Watch
    • Topics: Actuarial Profession>Professional development; Health & Disability>Payment models; Social Insurance>Medicare