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  • Developing a Population Health Management Program for a Long-Term Care Insurance Product
    Population Health Management Program for a Long-Term Care Insurance Product Medical management programs have ... premium-paying portion of a claimant's life. Health care costs;Health risks;Risk metrics;Disease management; ...

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    • Authors: Jeff Underhill, Don Fetterolf, Geoffrey Walton
    • Date: Dec 2007
    • Competency: Leadership>Thought leadership; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Long-Term Care News
    • Topics: Health & Disability>Health risks; Long-term Care>Chronic health management - Long-term Care; Technology & Applications>Analytics and informatics
  • Bariatric Surgery Holds Promise for Patients and for Payors
    Bariatric Surgery Holds Promise for Patients and for Payors An economic analysis ... health care costs supports the case for health plans to cover these procedures. Health care costs;Obesity;Value-based ...

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    • Authors: John Dawson, Pierre-Yves Cremieux, Arindam Ghosh
    • Date: Jan 2011
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Economics>Health economics; Experience Studies & Data; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining
  • Health Watch, Issue 79, December 2015, Health Watch
    teeism;Absenteeism;Smoking and mortality;health care reform;actuarial standards of practice;Regression ... efficiency;Product development;Health risks;Health care costs;marketing and distribution 6442465062 12/1/2015 ...

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    • Authors: Society of Actuaries
    • Date: Dec 2015
    • Competency: Communication>Written communication; External Forces & Industry Knowledge; Leadership>Influence; Professional Values>Ethical standards; Relationship Management>Team leadership; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; 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: Health Watch
    • Topics: Experience Studies & Data>Disability; Health & Disability>Critical illness insurance; Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks; Modeling & Statistical Methods>Modeling efficiency; Modeling & Statistical Methods>Regression analysis; Technology & Applications>Computer science
  • Medicare Advantage risk scores – Are you competitive?
    status of their populations continues to be a primary key to their success. This article updates those ... member based on ICD- 10 diagnosis codes from health care claims. A member is assigned an HCC if an ICD- 10 ...

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    • Authors: Corey Berger
    • Date: Oct 2018
    • Competency: Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Innovative solutions
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Social Insurance>Medicare
  • Calibrating Risk Score Model with Partial Credibility
    Risk adjustment models are commonly used in managed care programs to ensure that participating health plans ... commercial population. However, the variety of managed care populations (and benefits) is much larger than the ...
    • Authors: Sheamus Parkes, Brad Armstrong
    • Date: Oct 2015
    • Competency: Results-Oriented Solutions>Actionable recommendations; 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: Expanding Horizons
    • Topics: Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks; Modeling & Statistical Methods>Bayesian methods; Modeling & Statistical Methods>Data mining; Modeling & Statistical Methods>Estimation methods; Predictive Analytics
  • Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews
    The results are focused primarily on coordinated care plans (local HMOs, local PPOs and regional PPOs) ... Gender CHART 1 HCC Survey Results Coordinated Care Plan members (1) Includes All 70 HCCs (2) CHART ...

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    • 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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