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Better Care Through Understanding the Customer Not Just the Patient
As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical ... small fraction of their time in these facilities. This article explores what types of data are available ...- Authors: James Dolstad, Craig Cartossa, Justin Hartmann
- Date: Dec 2021
- Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Predictive Analytics; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques
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A Mental Health State of the Union
Health State of the Union This article is intended to inform readers about the current state of mental health ... care in the US, as were it's heading moving forward. Mental health care, wellness, major medical insurance ...- Authors: Traci Leigh Hughes
- Date: May 2023
- Competency: Results-Oriented Solutions
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care
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Integrating Claims-Based and Survey-Based Data to Estimate Program Savings
Savings An approach to quantify medical intervention savings when medical claims data is not available by ... by leveraging overlapping measurement techniques. Health care costs;Health care quality;Estimation Methods ...- Authors: Andrew Mackenzie, Ian G Duncan
- Date: Oct 2017
- Competency: Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Modeling & Statistical Methods>Estimation methods; Modeling & Statistical Methods>Regression analysis
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Prevalence of Supplemental Benefits in the Medicare Advantage Marketplace: 2017 to 2021
Prevalence of Supplemental Benefits in the Medicare Advantage Marketplace: 2017 to 2021 This article ... (MA) marketplace,[1] supplemental benefits are one of the primary ways Medicare Advantage organizations (MAOs) ...- Authors: Julia Friedman
- Date: Mar 2021
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Social Insurance>Medicare
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Give Me Some Credibility: Addressing the Challenge of Volatility in Value-Based Contracts—Part 2
Addressing the Challenge of Volatility in Value-Based Contracts—Part 2 Discover the key components of value-based ... credibility. Learn about benchmarks, measurement period results, and the unique challenges providers face ...- Authors: Maria Knox, James Pisko, Keith Passwater
- Date: May 2023
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Predictive Analytics; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques
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The Costs of Mental HealthParity
The Costs of Mental HealthParity This article examines the costs of mental health parity, presents the ... the primary drivers of cost increases from legislation and shows evidence the initial cost projections ...- Authors: Stephen P Melek
- Date: Mar 2005
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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Dental Diagnosis Coding: The State of the Art
Coding: The State of the Art Diagnostic coding in dental is in its infancy. This article explores the use ... use of medical diagnostic coding and how it may transform dental care in various ways. dental 6442476748 ...- Authors: Joanne E Fontana
- Date: Jun 2017
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance
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Possible Future of U.S. Healthcare
Possible Future of U.S. Healthcare What is the difference between a Single-Payer and Universal Health ... System, and how could the U.S. implement a system that would reduce the growth of medical costs while increasing ...- Authors: Roy Goldman
- Date: Nov 2019
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
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Restoring the Indifference Ideal: If It’s Not Adjusting for “Risk,” It’s Not “Risk Adjustment”
Restoring the Indifference Ideal: If It’s Not Adjusting for “Risk,” It’s Not “Risk Adjustment” ACA risk ... risk adjustment is intended to "bridge the gap" between allowed rates and actuarial rates. If risk adjustment ...- Authors: Greg Fann
- Date: Jun 2022
- Competency: Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Experience Studies & Data; Health & Disability>Health care
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Provider Risk-Sharing and Random Noise
Provider Risk-Sharing and Random Noise ... Discussion and Opinion on how randomness affects measurement of provider contracting risk-sharing agreements ...- Authors: Thomas Messer
- Date: Jul 2019
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Payment models; Health & Disability>Provider networks; Health & Disability>Provider risk