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  • The ACA’s Medical Loss Ratio Provisions: Looking Back
    The ACA’s Medical Loss Ratio Provisions: Looking Back The ACA’s Medical Loss Ratio Provisions Patient ...

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    • Authors: Rowen Bell
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • Whats going on here anyway?
    anyway? A Discussion of why female mortality is higher than male mortality at higher ages. Actual-to-expected=A/E=Actual ... experience;Contingencies;Death benefits;Differential mortality;Disability insurance;Disease management;Health ...

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    • Authors: John M Bragg
    • Date: May 2016
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Innovative solutions
    • Publication Name: Pension Section News
    • Topics: Actuarial Profession>Professional development; Demography>Gender factors; Demography>Longevity; Experience Studies & Data>Disability; Experience Studies & Data>Long-term care - Experience Studies & Data; Experience Studies & Data>Morbidity; Experience Studies & Data>Mortality; Health & Disability>Disability insurance; Health & Disability>Health care; Health & Disability>Health information technology; Health & Disability>Health insurance; Pensions & Retirement>Plan design
  • Reducing Medical Cost Trend With Concierge Services and Enhanced Digital Tools
    a 2016 study in JAMA Internal Medicine by Frank S. Drescher and Brenda E. Sirovich reports that advanced ... optimized their utilization in two ways, as shown in Table  1. First, they reduced their use of four categories ...

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    • Authors: Edward Cymerys
    • Date: Jun 2018
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Leadership>Thought leadership
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health information technology
  • Prologue
    it results in higher rates of mor- bidity and mortality for the uninsured and in some cases those around ... that in 2009— the year before the ACA was passed—U.S. health care spend- ing topped 16 percent of gross ...

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    • Authors: Jim Toole
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • The CLASS Act and its Aftermath
    guid- ance. Nevertheless, the Secre- tary of the U.S. Department of Health and Human Services had sufficient ... future workers. Currently, there are 217 million U.S. adults age 25 and over.9 In order to appreciate ...

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    • Authors: Robert Yee
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • Health Care Reform: Essential Health Benefits and Actuarial Value
    pre- ACA policies to do so.) In addition, the U.S. Depart- ment of Health and Human Services (HHS) ... required to cover the greater of one drug per U.S. Pharmaceutical (USP) category or class or the same ...

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    • Authors: Catherine Knuth
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • ACA Impact on Employers - The road ahead and the road behind
    size employers constitute 2 per- cent each of all U.S. employers and are subject to phased-in employer ... the United States. Per the report2 issued by the U.S. Census Bureau, over 169 million buy employment-based ...

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    • Authors: Sujaritha Tansen, Brian Stentz
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • Surplus and the ACA
    construct intended to be an early warn- ing system for U.S. insurance regulators and provide capital adequacy ... Considerations for a Managed Care Orga- nization”, © 2000 Milliman and Robertson, Inc. • NAIC RBC article:  ...

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    • Authors: Daniel Pribe
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • Assessing Prescription Opioid Risk with Predictive Analytics
    National Vital Statistics System. Mortality. CDC Wonder, Atlanta: U.S. Department of Health and Human ... Tamara M. Haegerich, and Roger Chou. Morbidity and Mortality Weekly Report: CDC Guideline for Prescribing ...

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    • Authors: Joseph Boschert, Andrew Gaffner, Barbara Collier
    • Date: Oct 2018
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making; Strategic Insight and Integration>Influence decisions; 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: Health Watch
    • Topics: Demography>Population data; Experience Studies & Data; Health & Disability>Health information technology; Modeling & Statistical Methods>Data mining; Predictive Analytics; Technology & Applications>Analytics and informatics; Health & Disability>Electronic medical record
  • Taxes and Fees Introduced by the ACA
    classes of insur- ers. As shown in the illustrative table in Figure 1, the amount by which the insurer would ... cases. The industry made an effort to lobby the U.S. De- partment of Health and Hu- man Services (HHS) ...

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    • Authors: Michael Gaal
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability