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Medicare Managed Care Organizations: Getting a Bigger Bang for the Buck
Medicare Managed Care Organizations: Getting a Bigger Bang for the Buck Panel discusses the effects of reduced payment levels to many Medicare managed care organizations. From the Record of the ...- Authors: Oscar Lucas, Peggy Tyndall
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health insurance; Social Insurance>Medicare
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Health Care Financing Systems Around the World
Health Care Financing Systems Around the World Presenter describes many of the desirable characteristics of a health care financing system, and alternative health care financing systems as they ...- Authors: Chiu-Cheng Chang
- Date: Jun 1998
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Global Perspectives; Health & Disability>Health care; Health & Disability>Payment models; Public Policy
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Profiling Physician Performance
Profiling Physician Performance Panelists discuss the methods HMOs employ to measure their providers' quality of care, outcomes, compliance with best practice guidelines, and cost ...- Authors: Joel C Hoffman, David Josephson, David Terry, John C Vataha, Kelly Myers
- Date: Jun 1999
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Actuarial Profession>Ethics; Economics>Health economics; Health & Disability>Health care; Health & Disability>Health care quality; Modeling & Statistical Methods>Regression analysis; Modeling & Statistical Methods>Simulation
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Working With Health Care Coalitions
Working With Health Care Coalitions Panel discussion about ways can insurance carriers and health care coalitions work together, what data are coalitions requesting from health carriers, how ...- Authors: Andrea B Castell, James P Hilferty, William H Rosenberg, Charles J Sherfey, Jean M Wodarczyk, Joseph H Rosmann
- Date: Oct 1986
- Competency: External Forces & Industry Knowledge>External forces and business performance; Leadership>Professional network leverage; Professional Values>Public interest representation; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Health & Disability>Health information technology; Technology & Applications>Analytics and informatics
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New Member Impact on Medicaid Managed Care Costs
New Member Impact on Medicaid Managed Care Costs In this article, the authors explore how the recession has impacted new member enrollment in the various state health care programs and the ...- Authors: Bela H Patel Fernandez, Jeffrey L Smith
- Date: Feb 2010
- Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Economics>Health economics; Experience Studies & Data>Morbidity; Social Insurance>Government-funded healthcare; Social Insurance>Medicaid
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Validating a Novel Health Insurance Fraud Detection Method
Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for ...- Authors: Robert D Lieberthal, Elias
- Date: Aug 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Effective decision-making; 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: Risk Management
- Topics: Economics>Health economics; Enterprise Risk Management; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Data mining; Predictive Analytics
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From The Editor
From The Editor A look into the issues’ contents. By Carlos Fuentes Models;Strategy;Artificial intelligence;Passion;Product development;Predictive modeling;Entrepreneurship By Carlos Fuentes What ...- Authors: Carlos Eduardo Fuentes
- Date: Nov 2017
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>General business skills; Leadership>Thought leadership; Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Innovators & Entrepreneurs
- Topics: Actuarial Profession>Management skills; Economics>Health economics; Economics>Macroeconomics; Modeling & Statistical Methods>Estimation methods
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Actuarial Aspects of the Changing Canadian Demographic Profile
Actuarial Aspects of the Changing Canadian Demographic Profile This paper reviews the recently published Canadian literature on changing Canadian demographic profiles and highlights the actuarial ...- Authors: Robert Brown
- Date: Oct 1982
- Competency: External Forces & Industry Knowledge>External forces and business performance; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Transactions of the SOA
- Topics: Demography>Population data; Economics>Health economics
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Twenty-Four-Hour Health Coverage
Twenty-Four-Hour Health Coverage This session is about regulatory constraints and the role the NAIC is playing to help facilitate 24-hour programs, plan design issues, the use of managed care, ...- Authors: James E Drennan, Godfrey Perrott, Eric C Nordman
- Date: Oct 1992
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Record of the Society of Actuaries
- Topics: Economics>Health economics; Health & Disability>Disability insurance; Health & Disability>Health insurance; Public Policy; Reinsurance>Product development - Reinsurance
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Review: “Health Insurance for ‘Humans’: Information Friction
Review: “Health Insurance for ‘Humans’: Information Friction A review of the academic article "Health Insurance for ‘Humans’: Information Frictions, Plan Choice, and Consumer ...- Authors: Christopher Coulter, Kathleen Dobrzynski, Tyler Engel, Dorothy Andrews
- Date: Nov 2016
- Competency: Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Economics>Behavioral economics; Economics>Health economics; Health & Disability>Health care