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Strategies for Leveraging the ACA Risk Adjuster
Strategies for Leveraging the ACA Risk Adjuster This article begins with a comparison of the commercial risk adjuster ... adjuster to the exisiting Medicare model, and goes on to discuss why the existing strategies employed ...- Authors: Jason Siegel
- Date: Oct 2013
- Competency: Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks
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Reaching Out for New Opportunities—New Market Research About Actuaries in the Health Care Industry
Actuaries in the Health Care Industry Key findings from a market research study which the SOA undertook ... undertook as part of their strategic initiative: Untapped Opportunities for Actuaries in Health. Analytics ...- Authors: Sara Teppema
- Date: May 2010
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Leadership>Professional network leverage; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Actuarial Profession>Alternative careers; Actuarial Profession>Qualifications
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Globalization of the Pharmaceutical Supply Chain: What are the Risks? The FDA’s Difficult Task
Globalization of the Pharmaceutical Supply Chain: What are the Risks? The FDA’s Difficult Task This ... talks about the challenges facing the FDA, especially those arising from the globalization of the pharmaceutical ...- Authors: Jill Van Den Bos
- Date: May 2009
- Competency: External Forces & Industry Knowledge; Professional Values>Public interest representation; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Health & Disability>Health care quality; Public Policy; Technology & Applications
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Understanding ORSA: Risk, Solvency and Beyond
discussion of the Risk Management and Own Risk and Solvency Assessment (RMORSA) Model Act that was recently ... recently approved by the NAIC and is being adopted by legislatures across the country. Own Risk Solvency ...- Authors: Elisabetta Russo, Lee H Resnick, Jacky Kwan
- Date: Jan 2014
- Competency: Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Incorporate risk management; 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: Enterprise Risk Management>Risk appetite; Enterprise Risk Management>Risk categories; Enterprise Risk Management>Risk measurement - ERM; Finance & Investments>Risk measurement - Finance & Investments
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Risk Adjustment in State Medicaid Programs
Medicaid Programs This article discusses some of the most important considerations in implementing risk ... Medicaid Managed Care program. From Health Watch, January 2008, No. 57. Managed care;Risk adjustment; ...- Authors: Robert Damler, Ross Winkelman
- Date: Jan 2008
- Competency: Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Social Insurance>Medicaid
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Modeling Anti-selective Lapse and Optimal Pricing in Individual and Small Group Health Insurance
Rather than being assumed at the outset, lapse rates emerge from the model, along with assessment spiral ... ratio projections. Under the model optimal pricing strategy depends on whether the class being rated has ...- Authors: D Wei
- Date: Feb 2010
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health risks; Modeling & Statistical Methods; Technology & Applications>Analytics and informatics
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Medicaid Work Requirements: Enrollment Impact of Different Policies
Requirements: Enrollment Impact of Different Policies Article provides a market scan of recent state proposals ... for Medicaid work requirements as well as measures the impact to enrollment in different states. Health ...- Authors: Colby Schaeffer, Nicholas Gersch
- Date: Jun 2018
- Competency: Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Forecasting
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What does ERM mean for Health Practitioners?
Practitioners? In this article, the author discusses the considerations and advantages of implementing an integrated ... health insurance company, and presents a summary of Aetna's experience with ERM as a case study.- Authors: Max Rudolph
- Date: Feb 2010
- Competency: External Forces & Industry Knowledge>External forces and business performance; Relationship Management>Staff management and motivation; Results-Oriented Solutions; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Economics>Health economics; Enterprise Risk Management; Modeling & Statistical Methods>Forecasting
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Enterprise Risk Management:One size does not fit all
measure of risk tolerance, particularly when evaluating a company relative to other insurers of similar ... size or type. The analysis shown in Exhibit 1 indicates that, as of Dec. 31, 2011, the industry has, ...- Authors: Mark W Whitford
- Date: Jan 2013
- Competency: Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Annuities>Investment strategy - Annuities; Enterprise Risk Management>Portfolio management - ERM; Finance & Investments>Asset allocation; Finance & Investments>Asset liability management; Finance & Investments>Investments