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Strategies for Leveraging the ACA Risk Adjuster
Strategies for Leveraging the ACA Risk Adjuster This article begins with a comparison of the commercial risk adjuster ... adjuster to the exisiting Medicare model, and goes on to discuss why the existing strategies employed ...- Authors: Jason Siegel
- Date: Oct 2013
- Competency: Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks
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The Individual ACA Market—What’s Next?
The Individual ACA Market—What’s Next? This article explores the changing risk profile between the transitional ... transitional Affordable Care Act (ACA) period (2014-2016) and under the final ACA period (beyond 2017) ...- Authors: Kurt Wrobel
- Date: Jan 2015
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: The Actuary Magazine
- Topics: Health & Disability>Health insurance; Pensions & Retirement>Risk management; Public Policy
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Medicare + Choices: Impact of Self-Selection
Medicare + Choices: Impact of Self-Selection Panelists discuss different aspects of self-selection among Medicare ... Medicare options. From the Record of the Society of Actuaries, Vol. 24, No. 2. Budgets;Chronic illness ...- Authors: Gregory Delamarter, Eric L Smithback, Dale Yamamoto, Sally T Burner, Roger Schacht
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>External forces and business performance; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability; Social Insurance>Government-funded healthcare; Social Insurance>Medicare
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Validating a Novel Health Insurance Fraud Detection Method
detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection ... Health care fraud;Predictive modeling;Medicare;Health insurance;Health economics;Health care costs;Data ...- 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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Health Insurance and the Valuation Actuary
Health Insurance and the Valuation Actuary Panelists discuss the role of the valuation actuary in health ... health insurance. From the Record of the Society of Actuaries, Vol. 24, No. 2. Asset valuation;Cash ...- Authors: Application Administrator, Michael Francescone, Frank E Knorr, Glenn A Giese
- 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>Incorporate risk management
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Disability insurance; Health & Disability>Health care; Health & Disability>Health insurance; Long-term Care>Long-term care insurance
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Risk Selection In Multiple Choice Benefit Programs
This session is about actuarial implications of individual choice, antiselection problems for medical ... benefits program experience, impact of alternative delivery systems on insured plan. Antiselection;Cafeteria ...- Authors: Ronald J Becker, Robert J Dymowski, Peter L Hutchings, Frank R Kopenski
- Date: Oct 1985
- Competency: Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health insurance
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Health Company Pandemic Modeling Tool
for a Society of Actuaries study examining the potential implications of a pandemic on the U.S. health ... health insurance industry. The spreadsheet is saved with many of the same assumptions used in this research ...- Authors: Jim Toole
- Date: Jun 2010
- Competency: Technical Skills & Analytical Problem Solving>Incorporate risk management
- Topics: Health & Disability>Health insurance; Modeling & Statistical Methods
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Financial Projection of Health Coverage - Short-Term Projections
Financial Projection of Health Coverage - Short-Term Projections Presented at September 1994 Valuation ...- Authors: Robert A Nelson
- Date: Sep 1994
- Competency: Technical Skills & Analytical Problem Solving>Incorporate risk management
- Topics: Enterprise Risk Management>Risk measurement - ERM; Health & Disability>Health insurance