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Provider-Sponsored Organizations PSOs
Provider-Sponsored Organizations PSOs Conditions and required solvency standards of federal waiver to PSOs to provide Medicare+Choice products. Effect on providers, beneficiaries and employers.- Authors: John Kinney
- Date: Dec 1998
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Public Policy; Social Insurance>Medicare
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What the Repeal and Replacement of the Affordable Care Act Will Look Like
What the Repeal and Replacement of the Affordable Care Act Will Look Like Republicans have promised to repeal and replace the Affordable Care Act for years. Now that they have power, what will ...- Authors: Joseph Slater, Joshua Strupcewski, John Culkin
- Date: Mar 2017
- Competency: Professional Values>Public interest representation
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Public Policy; Social Insurance>Government-funded healthcare; Social Insurance>Medicaid; Social Insurance>Medicare
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Medicare Advantage—Future Benchmarks
Medicare Advantage—Future Benchmarks This article discusses future benchmarks of Medicare and Medicare's rising costs and its relativity to the actuarial profession. Managed care;Payment ...- Authors: Application Administrator
- Date: May 2008
- Competency: External Forces & Industry Knowledge>External forces and business performance
- Publication Name: Health Watch
- Topics: Public Policy; Social Insurance>Medicare
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Soundbites from the American Academy of Actuaries’ Health Practice Council
Soundbites from the American Academy of Actuaries’ Health Practice Council Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate health care ...- Authors: Heather E Jerbi, Melissa Stevens
- Date: Sep 2009
- Competency: Communication>Written communication; Leadership>Influence; Professional Values>Public interest representation; Strategic Insight and Integration>Influence decisions
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional associations; Health & Disability>Health risks; Public Policy; Public Policy; Social Insurance>Medicare
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Early Findings from the ACA's Medicaid Expansion
Early Findings from the ACA's Medicaid Expansion Analysis of data from three Medicaid managed care plans examines enrollment and cost trends for newly eligible enrollees under the ...- Authors: Richard Marko, Sabrina Gibson, Joshua Kuai, Mitchell Cole
- Date: Oct 2018
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Leadership>Thought leadership; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Public Policy; Social Insurance>Medicaid
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Escaping the Addiction – From Preferred Payer to Rational Pricing
Escaping the Addiction – From Preferred Payer to Rational Pricing A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay ...- Authors: Hobson Carroll
- Date: Sep 2010
- Competency: Leadership>Thought leadership; Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view
- Publication Name: Health Watch
- Topics: Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability; Public Policy; Public Policy; Social Insurance>Medicaid; Social Insurance>Medicare
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Medicare Risk Funding
Medicare Risk Funding Two Medicare risk funding provisions that were radically changed by the BBA of 1997 funding variations by geographic area and risk adjustment. Issue No. 36 Payment reforms= ...- Authors: David Wille
- Date: Dec 1998
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Public Policy; Social Insurance>Medicare
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The Health Insurance Providers Fee and Medicaid
The Health Insurance Providers Fee and Medicaid This article describes the Health Insurance Providers Fee implemented through Section 9010 of the Affordable Care Act (ACA) and discusses how the ...- Authors: Sabrina Gibson, Maria Dominiak
- Date: Oct 2013
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>General business skills
- Publication Name: Health Watch
- Topics: Public Policy; Social Insurance>Government-funded healthcare; Social Insurance>Medicaid
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Medicare Supplement: Critical Factors for Success
Medicare Supplement: Critical Factors for Success An overview of the Medicare Supplement landscape and the critical factors for successfully pricing and managing this product line amidst the ...- Authors: James Galasso, John S Cathcart, Sudha Shenoy, Kenneth Clark
- Date: Jan 2011
- Competency: External Forces & Industry Knowledge; Professional Values>Practice expertise
- Publication Name: Health Watch
- Topics: Public Policy; Public Policy; Social Insurance>Government-funded healthcare; Social Insurance>Medicare
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Payment Reform Under The Medicare-Medicaid Financial Alignment Demonstration
Payment Reform Under The Medicare-Medicaid Financial Alignment Demonstration This article focuses on the capitation rate development methodology for the Medicare-Medicaid Financial Alignment ...- Authors: Michael Cook, Shelly Brandel
- Date: May 2013
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Public Policy; Social Insurance>Medicaid; Social Insurance>Medicare