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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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Health Watch, October 2017, Issue 84
Health Watch, October 2017, Issue 84 Read the October 2017 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section ...- Authors: Society of Actuaries
- Date: Oct 2017
- 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>Public financing - Health & Disability
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Medicare Managed Care Organizations: Getting a Bigger Bang for the Buck
Medicare Managed Care Organizations: Getting a Bigger Bang for the Buck Panel discusses the effects of reduced payment levels to many Medicare managed care organizations. From the Record of the ...- Authors: Oscar Lucas, Peggy Tyndall
- Date: Jun 1998
- 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: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health insurance; Social Insurance>Medicare
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Trends in Large Health Claims
Trends in Large Health Claims Panel discusses trends in large health claims, recent experience, and future expectations, as well as the impact of managed care on large individual health claims ...- Authors: David E Olsho, Anthony Wittmann, Daniel Wolak, Larry Jackson
- Date: Jun 1999
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health insurance; Health & Disability>Health risks
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Integrating Cost, Efficiency and Quality Data into Provider Reimbursement
Integrating Cost, Efficiency and Quality Data into Provider Reimbursement The measure of a health-care provider's quality and efficiency can be used to reward or penalize the provider ...- Authors: Ralph D Alexander, John Cookson
- Date: Jun 2002
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health insurance
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Financial Projection of Health Coverages - Long-Term Projections
Financial Projection of Health Coverages - Long-Term Projections This session from the 1994 Valuation Actuary Symposium focuses on long-term projections of health insurance, the uses of the ...- Authors: Helen L Hofmann, Ronald M Wolf, Robert Yee
- Date: Jan 1993
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
- Topics: Health & Disability>Health insurance
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Aging Curves for Health Care Costs in Retirement
Aging Curves for Health Care Costs in Retirement This study was sponsored by the Society of Actuaries Health Section. This paper explores the relative significance of aging as a determinant of ...- Authors: Jeffrey Petertil
- Date: Aug 2003
- Competency: External Forces & Industry Knowledge; External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context
- Topics: Health & Disability>Health care; Public Policy; Social Insurance>Medicare
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An Introduction To Care Management Interventions And Their Implications For Actuaries - Paper 1: Programs and Interventions
An Introduction To Care Management Interventions And Their Implications For Actuaries - Paper 1: Programs and Interventions This paper describes seven methods used in care management in the ...- Authors: Ian G Duncan, Henry Dove
- Date: Aug 2004
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
- Topics: Health & Disability>Chronic health management - Health & Disability
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Predicting Return to Work with Data Mining
Predicting Return to Work with Data Mining 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 ...- Authors: Barry D Senensky,
- Date: Jan 2004
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>External forces and business performance
- Topics: Health & Disability>Chronic health management - Health & Disability; Health & Disability>Disability insurance; Health & Disability>Disability tables; Modeling & Statistical Methods>Dynamic simulation models; Modeling & Statistical Methods>Markov Chain; Modeling & Statistical Methods>Modeling efficiency; Modeling & Statistical Methods>Simulation
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Estimating Savings, Utilization Rate Changes, and Return on Investment from Care Management Interventions - Selective Literature review of Care Management Interventions
Estimating Savings, Utilization Rate Changes, and Return on Investment from Care Management Interventions - Selective Literature review of Care Management Interventions A review of literature ...- Authors: Ian G Duncan, Henry Dove
- Date: Mar 2005
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
- Topics: Health & Disability>Chronic health management - Health & Disability