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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 ...- 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
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Medicare Advantage—Future Benchmarks
Medicare Advantage—Future Benchmarks This article discusses future benchmarks of Medicare and Medicare's rising costs and its relativity to the actuarial profession. Managed care;Payment ...- 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
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Considerations for Surplus Determination under ACA
Considerations for Surplus Determination under ACA Discussion of the impact of the ACA on RBS and required surplus for a health plan Risk-based capital=RBC;Patient Protection and Affordable Care ...- 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
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Medicare Advantage Part C Revenue: Challenges Ahead
Medicare Advantage Part C Revenue: Challenges Ahead Analysis of the projected impact of the Affordable Care Act on Medicare Part C revenue over 2014 through 2017, with background on recent ...- Authors: Timothy Courtney
- Date: Jan 2013
- Competency: External Forces & Industry Knowledge>External forces and business performance
- Publication Name: Health Watch
- Topics: Public Policy
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The Evolution of the Individual Market (Part II)
The Evolution of the Individual Market (Part II) Part II of a two-part series discussing individual market evolution from before the ACA through President Trump's first term. Individual ...- 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
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Behind Clinical Integration
Behind Clinical Integration Recent health care reform activity has highlighted the importance of Clinical Integration in improving the quality, safety, efficiency and reimbursement infrastructure ...- Authors: Steven Tutewohl
- Date: May 2010
- Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Public interest representation; Strategic Insight and Integration>Effective decision-making
- Publication Name: Health Watch
- Topics: Health & Disability>Health information technology; Public Policy; Technology & Applications>Data warehousing; Health & Disability>Electronic medical record
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Accountable Care Organizations: An Untapped Opportunity
Accountable Care Organizations: An Untapped Opportunity Since health care reform has made accountable care organizations a hot topic, an SOA workgroup is addressing relevant questions, including ...- 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
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Commercial Healthcare: What's Next
Commercial Healthcare: What's Next A new initiative, Commercial Health Care: What’s Next, will focus on education and research for health actuaries regarding issues that remain with the ...- 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
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The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries
The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries Explanation of Medicare Advantage STAR rating program as it relates to payment rates for MA bids. Also describes ...- 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