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Profiling Physician Performance
Profiling Physician Performance Panelists discuss the methods HMOs employ to measure their providers' quality of care, outcomes, compliance with best practice guidelines, and cost ...- Authors: Joel C Hoffman, David Josephson, David Terry, John C Vataha, Kelly Myers
- Date: Jun 1999
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Actuarial Profession>Ethics; Economics>Health economics; Health & Disability>Health care; Health & Disability>Health care quality; Modeling & Statistical Methods>Regression analysis; Modeling & Statistical Methods>Simulation
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Health Section Issues New IBNR Study
Health Section Issues New IBNR Study Summary of the health section council’s research project to assess the accuracy of commonly used IBNR estimation methods over a wide range of scenarios.- Authors: Steven Siegel, Cabe Chadick
- Date: Feb 2010
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Assess decision effectiveness; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Actuarial Profession>Standards of practice; Financial Reporting & Accounting; Health & Disability>Health care; Modeling & Statistical Methods>Modeling efficiency
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Validating a Novel Health Insurance Fraud Detection Method
Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for ...- Authors: Robert D Lieberthal, Elias
- Date: Aug 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Economics>Health economics; Enterprise Risk Management; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Data mining; Predictive Analytics