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Design and Pricing of Tiered Network Health Plans
Design and Pricing of Tiered Network Health Plans This article discusses the advantages, logistical concerns, and pricing formulas of implementing a TNHP, in which members pay less for treatment ...- Authors: Peter Horman
- Date: May 2009
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health care quality; Modeling & Statistical Methods
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An Interview: Dr. Uwe Reinhardt
An Interview: Dr. Uwe Reinhardt In this interview Dr. Reinhardt shares his thoughts on the role he believes actuaries should take in the health care system reforms. Assumptions;Episode-based ...- Authors: Mary Kindel Van der Heijde, Douglas Norris
- Date: Sep 2009
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Leadership>Thought leadership; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Actuarial Profession>Traditional careers; Enterprise Risk Management; Health & Disability>Health risks; Health & Disability>Payment models
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Assessing Prescription Opioid Risk with Predictive Analytics
Assessing Prescription Opioid Risk with Predictive Analytics We highlight a new approach leveraging predictive analytics to identify high risk and rising risk opioid users for more effective ...- Authors: Joseph Boschert, Andrew Gaffner, Barbara Collier
- Date: Oct 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making; Strategic Insight and Integration>Influence decisions; 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: Demography>Population data; Experience Studies & Data; Health & Disability>Health information technology; Modeling & Statistical Methods>Data mining; Predictive Analytics; Technology & Applications>Analytics and informatics; Health & Disability>Electronic medical record