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The Missing 1 Percent
The Missing 1 Percent A discussion of insurance claims processing and payment systems, and how to achieve the minimum possible number of errors. Audits;Claims processing;Claims review;Data ...- Authors: Jim Del Vecchio
- Date: May 2010
- Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Long-Term Care News
- Topics: Health & Disability>Health information technology; Health & Disability>Electronic medical record
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Medicare Advantage risk scores – Are you competitive?
Medicare Advantage risk scores – Are you competitive? What you need to know about risk scores to be competitive in the Medicare Advantage market. Medicare;Risk adjustment;Health insurance;Return ...- 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
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Health Watch, Issue 79, December 2015, Health Watch
Health Watch, Issue 79, December 2015, Health Watch Health Watch, Issue 79, December 2015, Health Watch Critical illness insurance;Ethics;Health reserves;Health Research;Cause-of-death mortality; ...- 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
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From the Outside Looking In: Helping People Age (Safely) in
From the Outside Looking In: Helping People Age (Safely) in Describes benefits of updating homes for aging in place. Calls for stakeholders coalition of: building & tech sectors, LTCI, ...- Authors: Louis Tenenbaum
- Date: Apr 2018
- Competency: Communication>Difficult message delivery; Leadership>Thought leadership; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Long-Term Care News
- Topics: Demography>Longevity; Economics>Behavioral economics; Economics>Health economics; Experience Studies & Data>Disability; Experience Studies & Data>Morbidity; Health & Disability
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Bundled Reimbursement: A Step in the Right Direction, or Another Flawed Idea?
Bundled Reimbursement: A Step in the Right Direction, or Another Flawed Idea? An overview of the issues behind reimbursing providers on a bundled or packaged basis. The article presents the ...- Authors: Todd Lueders
- Date: Sep 2010
- Competency: External Forces & Industry Knowledge; Professional Values>Public interest representation; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health care quality; Public Policy; Public Policy
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Palliative Care
Palliative Care This article from major US payers describes palliative care as a scaleable means of improving quality and reducing costs during serious and complex illness. Payment models=Health ...- Authors: Randall Krakauer, Bruce Smith, Diane Meier, Torrie Fields
- Date: Nov 2016
- Competency: Leadership>Change management; Leadership>Influence; Leadership>Mentoring; Leadership>Professional network leverage; Leadership>Thought leadership; Results-Oriented Solutions>Actionable recommendations; Results-Oriented Solutions>Assess decision effectiveness; Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Effective decision-making
- Publication Name: Health Watch
- Topics: Economics>Health economics; Enterprise Risk Management>Systematic risk; Experience Studies & Data>Morbidity; Experience Studies & Data>Mortality; Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care quality; Health & Disability>Payment models
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Navigating Cost-Sharing Reduction Subsidy Defunding
Navigating Cost-Sharing Reduction Subsidy Defunding This paper will examine why CSR defunding produces pricing uncertainty and how regulators can alleviate these risks when insurers price 2020 ...- Authors: Michael Cohen, Peter van Laarhoven
- Date: Mar 2019
- Competency: Professional Values>Practice expertise; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Public Policy