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Medicare Managed Care Organizations: Getting a Bigger Bang for the Buck
Medicare Managed Care Organizations: Getting a Bigger Bang for the Buck Panel discusses the effects of reduced payment levels to many Medicare managed care organizations. From the Record of the ...- Authors: Oscar Lucas, Peggy Tyndall
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health insurance; Social Insurance>Medicare
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Health Care Financing Systems Around the World
Health Care Financing Systems Around the World Presenter describes many of the desirable characteristics of a health care financing system, and alternative health care financing systems as they ...- Authors: Chiu-Cheng Chang
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Global Perspectives; Health & Disability>Health care; Health & Disability>Payment models; Public Policy
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Profiling Physician Performance
Profiling Physician Performance Panelists discuss the methods HMOs employ to measure their providers' quality of care, outcomes, compliance with best practice guidelines, and cost ...- Authors: Joel C Hoffman, David Josephson, David Terry, John C Vataha, Kelly Myers
- Date: Jun 1999
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Actuarial Profession>Ethics; Economics>Health economics; Health & Disability>Health care; Health & Disability>Health care quality; Modeling & Statistical Methods>Regression analysis; Modeling & Statistical Methods>Simulation
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Validating a Novel Health Insurance Fraud Detection Method
Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for ...- Authors: Robert D Lieberthal, Elias
- Date: Aug 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Economics>Health economics; Enterprise Risk Management; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Data mining; Predictive Analytics
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Review: “Health Insurance for ‘Humans’: Information Friction
Review: “Health Insurance for ‘Humans’: Information Friction A review of the academic article "Health Insurance for ‘Humans’: Information Frictions, Plan Choice, and Consumer ...- Authors: Christopher Coulter, Kathleen Dobrzynski, Tyler Engel, Dorothy Andrews
- Date: Nov 2016
- Competency: Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Economics>Behavioral economics; Economics>Health economics; Health & Disability>Health care
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Human Nature and the US Health Care System, Part I
Human Nature and the US Health Care System, Part I The third in a series of four articles that illustrate the “soft” approach of game theory using Thucydides’ master work, The History of the ...- 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