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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 ...- 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
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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 ...- 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
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Hospital Entry Into Health Care Financing
Hospital Entry Into Health Care Financing Presented at October 1986 Annual Meeting. Discussion ... risks and financial incentives from the hospital's perspective, and whether hospitals are marginally ...- Authors: John Fritz, Ronald D Osborne, Virginia S Olds, Clifford Keith Powell
- Date: Oct 1986
- Competency: External Forces & Industry Knowledge>External forces and business performance; Strategic Insight and Integration>Strategy development
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Payment models
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At the Intersection of Public Health and Actuarial Practice
effective. Despite actuaries’ major role in the U.S. health care system, even a basic overview of the ... significant predictors of health outcomes. More excess mortality in the United States, for instance, is attributable ...- Authors: Barbara Zabielski
- Date: Oct 2017
- Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Public interest representation
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional associations; Health & Disability>Health care; Health & Disability>Payment models; Public Policy; Social Insurance>Medicaid
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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 ...- 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
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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 ...- 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
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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 ...- 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
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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: ...- 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
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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) ...- 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
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Pricing Issues Resulting from Budget Setting and Stoploss in ACO Arrangements
Pricing Issues Resulting ... In n e R S o f T h e h e A lT h W A T C h A R T IC l e C o n T e S T 30 | ... decrease in quality. The insurer and ACO provider(s) should develop clear definitions of quality and ...- Authors: Anthony Rubiano
- Date: May 2012
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks; Health & Disability>Payment models; Public Policy