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Our Value-Based Cup Runneth Over
Our Value-Based Cup Runneth Over Discussion of how to mature value-based contracts between health insurers and provider organizations to improve population health and financial sustainability.- Authors: Daniel Reck (Dan), Lisa Swan, Sam Johnmeyer
- Date: Aug 2022
- Competency: Communication; External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Enterprise Risk Management>Risk appetite; Enterprise Risk Management>Risk measurement - ERM; Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models; Health & Disability>Provider risk
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Responsible Machine Learning: Living Up to Our Professional Code of Conduct, ASOPs, and Corporate Requirements
Responsible Machine Learning: Living Up to Our Professional Code of Conduct, ASOPs, and Corporate Requirements Actuaries are leveraging predictive modeling and machine learning more and more as ...- Authors: James Dolstad, Abby Steele
- Date: Aug 2022
- Competency: Professional Values; Results-Oriented Solutions; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Predictive Analytics
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Response to March 2021 Practice Note on ASOP 6
Response to March 2021 Practice Note on ASOP 6 Response to March 2021 Practice Note on ASOP 6 blockquote { margin: 10px 20px 20px 20px; } .block-2 { margin: 10px 20px 20px 40px; } th, td { ...- Authors: Charles Edwards
- Date: Aug 2022
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Experience Studies & Data>Morbidity; Health & Disability>Health care
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Medicare Supplement and FASB’s Long-Duration Targeted Improvements Project Part II: Conclusions
Medicare Supplement and FASB’s Long-Duration Targeted Improvements Project Part II: Conclusions In ...- Authors: Rowen Bell
- Date: Aug 2021
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Financial Reporting & Accounting; Financial Reporting & Accounting>Generally Accepted Accounting Principles [GAAP]; Health & Disability; Health & Disability>Health insurance
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Understanding Health in the Big Picture
Understanding Health in the Big Picture Social determinants of health (SDoH) have been a topic of growing interest in recent years, yet consensus about what the phrase represents and how ...- Authors: Jill Van Den Bos, Stoddard Davenport
- Date: Aug 2021
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health risks
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Telehealth at a Crossroads
Two years ago, before COVID-19 changed everything about how we provide and receive health care, telehealth was largely provided by third-party vendors to treat a narrow range of acute ...- Authors: Kirsten Staveland, Brian Parkinson
- Date: Dec 2021
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Health & Disability; Public Policy
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Understanding the Medical Stop-Loss Market
Understanding the Medical Stop-Loss Market This article details the medical stop-loss coverages purchased by HMOs, small insurers and providers taking delegated financial risk in payor ...- Authors: Keith Passwater, Peter Robinson, David Nelson
- Date: Jun 2022
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Reinsurance; Health & Disability>Provider risk
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Better Care Through Understanding the Customer Not Just the Patient
As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet ...- Authors: James Dolstad, Craig Cartossa, Justin Hartmann
- Date: Dec 2021
- Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Predictive Analytics; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques
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Restoring the Indifference Ideal: If It’s Not Adjusting for “Risk,” It’s Not “Risk Adjustment”
Restoring the Indifference Ideal: If It’s Not Adjusting for “Risk,” It’s Not “Risk Adjustment” ACA risk adjustment is intended to "bridge the gap" between allowed rates and actuarial rates.- Authors: Greg Fann
- Date: Jun 2022
- Competency: Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Experience Studies & Data; Health & Disability>Health care