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  • Pricing Issues Resulting from Budget Setting and Stoploss in ACO Arrangements
    Pricing Issues Resulting from Budget Setting and Stoploss in ACO Arrangements This article will consider several issues arising from ACO budgeting and pricing of stoploss coverage, including: 1) ...

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    • 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
  • Regulation Of Preferred Provider Organizations 'PPOs' And Other Alternate Delivery Systems
    Regulation Of Preferred Provider Organizations 'PPOs' And Other Alternate Delivery Systems Presented at June 1986 Spring Meeting. This session discussion is about the status of ...

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    • Authors: Sandra Drew Anderson, Jay P Boekhoff, James D Clements, Floyd Martin
    • Date: Jun 1986
    • Competency: External Forces & Industry Knowledge>External forces and business performance
    • Publication Name: Record of the Society of Actuaries
    • Topics: Health & Disability>Payment models; Public Policy
  • At the Intersection of Public Health and Actuarial Practice
    At the Intersection of Public Health and Actuarial Practice An edited written interview with two actuaries and a public health professional on issues related to the intersection between the two ...

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    • 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
  • The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries
    The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries Explanation of Medicare Advantage STAR rating program as it relates to payment rates for MA bids. Also describes ...

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    • Authors: Adrian L Clark, Gabriela Dieguez, Bradley James Piper
    • Date: May 2012
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy