Description: Report from research project that reviewed and inventoried the range of quality and efficiency measures that demonstrate the performance of hospitals and physicians. Besides outlining key areas of consideration for quality and efficiency measurement, this report also describes future opportunities for actuaries and other health professionals interested in this evolving area. The inventory part of the report is in a separate document.

Description: One of the first projects undertaken by Claim Analytics was to create a model to predict return to work for group insurance claimants with long term disabilities. This report, sponsored in part by the Society of Actuaries Health Section , is a case study on creating such a model.

Description: The Health Plan Employee Data and Information Set 'HEDIS' is a set of standardized performance measures initially designed to enable purchasers of health care to evaluate and compare a managed care plan’s administrative performance. The National Committee for Quality Assurance, known as the NCQA, developed HEDIS in 1991. Since its introduction, HEDIS has become a widely used tool for measuring a broad array of health plan functions. This study evaluates the reliability and validity of HEDIS measures. It also reviews the usefulness of HEDIS as an indicator of health care quality.

Description: Research project that reviewed and inventoried the range of quality and efficiency measures that demonstrate the performance of hospitals and physicians. Besides outlining key areas of consideration for quality and efficiency measurement, this report also describes future opportunities for actuaries and other health professionals interested in this evolving area. The inventory part of this report is in a separate document.

Description: WeChat is gradually becoming the main force of insurance online marketing for insurance products in China.

Description: The report details data from a number of carriers on the percentage of LTD claimants who are receiving disability benefits from other sources that offset their LTD benefits and how this percentage is affected by various factors.

Description: This is a final report to help individual health plans evaluate and manage their potential exposure during a specific pandemic. It examines the potential impact of pandemic influenza on different payers in the U.S. health care system.

Description: This is the inventory part of the report from the research project that reviewed and inventoried the range of quality and efficiency measures currently available for healthcare. The goal was to outline key areas of quality and efficiency measurement and identify future opportunities for actuaries. The inventory lists the resources and provides brief descriptions of their services with links.

Description: This paper examines five alternative valuation methods - prospective, retrospective, global, intermediate, and static - for the proper application of GAAP to Medicare supplement insurance. The focus of this paper is on the changes to expected future claim costs due to changes in the Medicare deductibles.

Description: This is the inventory part of the report from the research project that reviewed and inventoried the range of quality and efficiency measures currently available for healthcare. The goal was to outline key areas of quality and efficiency measurement and identify future opportunities for actuaries. The inventory lists the resources and provides brief descriptions of their services with links.