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  • Biosimilars, Part 5: Payer Decision Making
    decision-making? prescription drug costs, managed care By Gregory Warren and Tony Pistilli Health Watch ... generally have some essential requirements, one primary goal and a couple secondary goals (Figure 1). Figure ...

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    • Authors: Greg Warren, Tony Pistilli
    • Date: Jan 2024
    • Competency: External Forces & Industry Knowledge
    • Publication Name: Health Watch
    • Topics: Health & Disability; Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care; Health & Disability>Health insurance
  • A Patient Centric Approach to AI in Health Insurance
    A Patient Centric Approach to AI in Health Insurance The article explores how integrating AI into insurer apps can address critical ... adherence. Prescription drug costs, Preventive care 5/1/2024 12:00:00 AM ...

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    • Authors: Scott Damery
    • Date: May 2024
    • Competency: Results-Oriented Solutions
    • Topics: Health & Disability; Health & Disability>Health insurance; Technology & Applications; Technology & Applications>Artificial intelligence & machine learning
  • Society of Actuaries Analyzes Pharmacy Ecosystem in New Study
    cost of care. The research uses a value-based methodology. pharma, pharma financing, cost of care March ... incentives and mitigate increases in total cost of care (TCOC). The research uses a value-based methodology ...

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    • Date: Mar 2024
    • Competency: External Forces & Industry Knowledge; Results-Oriented Solutions
    • Topics: Health & Disability; Health & Disability>Health insurance
  • Issue Brief: Changing Financial Risks for Medigap Insurance, Part 2
    (snowbirds, for example); and cover their major health care needs without MA’s utilization reviews and the risk ... as well as likely delays in receiving necessary care.[4] Providers may also appreciate Medigap-covered ...

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    • Date: Mar 2024
    • Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
    • Publication Name: Health Watch
    • Topics: Health & Disability; Health & Disability>Health insurance; Public Policy; Public Policy
  • Using Interpretable Machine Learning Methods: An Application to Health Insurance Fraud Detection
    distinct advantages for enhancing fraud detection. A primary advantage lies in their rapidity of generating ... Machine Learning (IML) techniques. However, our primary focus throughout the remainder of this paper will ...

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    • Date: Jan 2024
    • Topics: Health & Disability; Health & Disability>Health insurance; Technology & Applications; Technology & Applications>Artificial intelligence & machine learning
  • Issue Brief: Changing Financial Risks for Medigap Insurance, Part 1
    patients who deferred certain types of care or simply sought less care than they normally would (or should) ... financial improvements due to delayed and averted care in 2020 and 2021 than did other types of health ...

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    • Authors: Kristi Bohn
    • Date: Mar 2024
    • Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
    • Publication Name: Health Watch
    • Topics: Health & Disability; Health & Disability>Health insurance