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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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Is Your Integrated Delivery System Throwing Away Free Money?
Is Your Integrated Delivery System Throwing Away Free Money? Article explores why many integrated delivery systems are struggling and what actions they need to take to succeed. Medicare;aligned ...- Authors: Karan Rustagi
- Date: Feb 2018
- Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional development; Health & Disability>Payment models; Social Insurance>Medicare
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The Modernization of Medigap Plans-Legislative Summary
The Modernization of Medigap Plans-Legislative Summary This article discusses the legislative summary of the changes that will occur with the new Medigap policies, which will be effective on or ...- Authors: Marianne Miller
- Date: Jan 2009
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Social Insurance>Medicare
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The Modernization of Medigap Plans–Managing the Change
The Modernization of Medigap Plans–Managing the Change This article discusses planning for the changes that will occur with the new Medigap policies, which will be effective on or after June 1, ...- Authors: Gail M Lawrence
- Date: Jan 2009
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Social Insurance>Medicare
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Medicaid Innovation: The Need for Actuaries in the Medicaid Program
Medicaid Innovation: The Need for Actuaries in the Medicaid Program Background on Medicaid and description of recent changes in the program. Medicaid;Payment Reform;Payment Models;Social ...- Authors: Christine Bach
- Date: May 2016
- Competency: Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Social Insurance>Medicaid
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Full Medicare Part D Coverage through the Gap—an Endangered Benefit?
Full Medicare Part D Coverage through the Gap—an Endangered Benefit? This article takes a closer look at Medicare Part D Coverage and the types of payment demonstration payment of the federal ...- Authors: Julia Lambert
- Date: Jan 2009
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Social Insurance>Medicare
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Navigating New Horizons …an interview with Eduardo Lara di Lauro
Navigating New Horizons …an interview with Eduardo Lara di Lauro A Mexican actuary discusses his career, the challenges of different insurance markets in different cultures, the value of sharing ...- Authors: Sarah Lawrence
- Date: Feb 2010
- Competency: External Forces & Industry Knowledge; Leadership>Change management; Professional Values>Practice expertise; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Actuarial Profession; Public Policy; Social Insurance>Government-funded healthcare