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Improving Medicare Advantage Star Ratings: An Analytical Framework
uments-Items /2018Advance.html (accessed August 17, 2018). 2 Centers for Medicare and Medicaid Services ... -Ratings-Technical-Notes-2017_09_06.pdf (accessed August 17, 2018). 3 Centers for Medicare and Medicaid Services ...- Authors: Puneet Budhiraja, Rajesh Munjuluri
- Date: Oct 2018
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability; Technology & Applications>Analytics and informatics
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A Comparison Between the ACA Exchange and Medicare Risk Adjustment Programs
77 Health Watch | January 2015 | 17 A Comparison Between the ACA Exchange and Medicare ... Between the ACA Exchange and Medicare | FROM PAGE 17 Risk Score Basis Applicable Payment Period Historical ...- Authors: Kurt Wrobel
- Date: Jan 2015
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Social Insurance>Medicare
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Possible Future of U.S. Healthcare
disease accounting for 90 percent of health care costs,17 I have heard estimates that as much as 50 percent ... Journal of the Amer- ican Medical Association 318, no. 17. https://jamanetwork.com/journals/jama/ fullarticle/2661579 ...- Authors: Roy Goldman
- Date: Nov 2019
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
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Health Watch, February 2018, Issue 85
FPL 24% 150–200% FPL 17% 200–250% FPL 3% FEBRUARY 2018 HEALTH WATCH | 17 Nineteen State Attorneys ... reimbursements; spread evenly across all plans. 17 Silver Load Insurers load premiums to cover loss ...- Authors: Society of Actuaries
- Date: Feb 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- 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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Massachusetts Payment Reform from an Actuarial Perspective
truncating large claims. Health Watch | May 2013 | 17 ContInUEd on page 18 The twin goals of the AQC ... Health Watch Massachusetts payment … | froM page 17 moved to network-based trends, the health status ...- Authors: Matthew Day, Jill Wilson
- Date: May 2013
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Payment models; Public Policy
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At the Intersection of Public Health and Actuarial Practice
health information, improving living conditions, etc.”17 It’s the “etc.” where the nuance lies. Public Health ... countyhealthrankings.org/our-approach (accessed August 18, 2017). 17 Definition of Public Health for English Language ...- 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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An Actuarial Model to Improve Health and Reduce Costs
unnecessary if the underlying cause is addressed.17 The clinical, scientific and historical evidence ... icle.jsp#.WVj0r7ldnIU (accessed June 30, 2017). 17 James Craner, Hypertension: A Silent Dietary Disease ...- Authors: Ken Beckman
- Date: Oct 2017
- Competency: Leadership>Thought leadership; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy
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The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries
Service The 2012 Part D summary rating consists of 17 individual measures for a Medicare Advantage Prescription ... Prescription Drug (MAPD) plan and the same 17 measures for a PDP, which are categorized into four separate ...- 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
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Examining the Evidence - Enhanced Primary Care Leads to Reduced Hospital Use and Saves Costs - Or Does It?
program appeared in the Annals of Family Medicine.17 While the PCCM program has improved access, enhanced ... Findings Are False. PLoS Medicine, August 2005. 17 Phillips, R.L., M. Han, S.M. Petterson, L.A. Makaroff ...- Authors: Tia Sawhney, Bruce Pyenson
- Date: Jan 2015
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health risks; Health & Disability>Payment models
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Why so Many People Have Untreated Mental Health Conditions
health issues.” I am not talking about only the one in 17 Americans who lives with a diagnosed serious mental ... mental health issue. JUNE 2018 HEALTH WATCH | 17 • Mental illness is associated with an increased ...- Authors: Dawn Motovidlak
- Date: Jun 2018
- Competency: Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models