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What the Repeal and Replacement of the Affordable Care Act Will Look Like
What the Repeal and Replacement of the Affordable Care Act Will Look Like Republicans have promised to repeal and replace the Affordable Care Act for years. Now that they have power, what will ...- Authors: Joseph Slater, Joshua Strupcewski, John Culkin
- Date: Mar 2017
- Competency: Professional Values>Public interest representation
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Public Policy; Social Insurance>Government-funded healthcare; Social Insurance>Medicaid; Social Insurance>Medicare
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Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews
Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the ...- Authors: Corey Berger, Eric P Goetsch
- Date: Jan 2011
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Demography; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining; Social Insurance>Medicare; Technology & Applications>Analytics and informatics
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Soundbites from the American Academy of Actuaries’ Health Practice Council
Soundbites from the American Academy of Actuaries’ Health Practice Council Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate health care ...- Authors: Heather E Jerbi, Melissa Stevens
- Date: Sep 2009
- Competency: Communication>Written communication; Leadership>Influence; Professional Values>Public interest representation; Strategic Insight and Integration>Influence decisions
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional associations; Health & Disability>Health risks; Public Policy; Public Policy; Social Insurance>Medicare
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Medicare Advantage Hierarchical Condition Categories: Updated Study Results
Medicare Advantage Hierarchical Condition Categories: Updated Study Results Summary and analysis of the diseases and conditions exhibited in the Medicare Advantage population Medicare;Risk ...- Authors: Corey Berger, Eric P Goetsch
- Date: Jan 2013
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks; Social Insurance>Medicare
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Escaping the Addiction – From Preferred Payer to Rational Pricing
Escaping the Addiction – From Preferred Payer to Rational Pricing A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay ...- Authors: Hobson Carroll
- Date: Sep 2010
- Competency: Leadership>Thought leadership; Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability; Public Policy; Public Policy; Social Insurance>Medicaid; Social Insurance>Medicare
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A Comparison Between the ACA Exchange and Medicare Risk Adjustment Programs
A Comparison Between the ACA Exchange and Medicare Risk Adjustment Programs Risk adjustment is used to adjust the revenue stream to health insurers that sell ACA eligible plans and Medicare ...- 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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Payment Reform Under The Medicare-Medicaid Financial Alignment Demonstration
Payment Reform Under The Medicare-Medicaid Financial Alignment Demonstration This article focuses on the capitation rate development methodology for the Medicare-Medicaid Financial Alignment ...- Authors: Michael Cook, Shelly Brandel
- Date: May 2013
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Public Policy; Social Insurance>Medicaid; Social Insurance>Medicare
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Similarities between Medicare Prescription Drug Plans and Commercial Exchanges
Similarities between Medicare Prescription Drug Plans and Commercial Exchanges This article compares the Prescription Drug Plan (PDP) market to the commercial individual market exchanges included ...- Authors: Shelly Brandel
- Date: Jan 2013
- Competency: Strategic Insight and Integration>Strategy development
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Public Policy; Public Policy; Social Insurance>Medicare
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Letter from the Editors
Letter from the Editors The editors of Health Watch have made health care reform the focus of the Sepctember 2009 issue, and provide an introduction to the issue's contents. Health care ...- Authors: Grady Catterall, Mary Kindel Van der Heijde
- Date: Sep 2009
- Competency: Communication>Written communication; External Forces & Industry Knowledge>Actuarial theory in business context; Leadership>Thought leadership; Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health care quality; Public Policy; Social Insurance>Medicare
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Medicare Advantage: Seven Considerations to Achieve August Resubmission Success
Medicare Advantage: Seven Considerations to Achieve August Resubmission Success Strategies to position Medicare Advantage plans for success during August resubmission. rebate reallocation; ...- Authors: Susan Silseth, Matthew Timm, Kelly Backes, Hillary Millican
- Date: Oct 2017
- Publication Name: Health Watch
- Topics: Actuarial Profession>Best practices; Health & Disability>Health care; Health & Disability>Health insurance; Social Insurance>Medicare