1
-
10
of
11
results (0.33 seconds)
Sort By:
-
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
-
An Executive Roundtable on the State of Predictive Analytics in U.S. Health Care
An Executive Roundtable on the State of Predictive Analytics in U.S. Health Care Many executives are talking about predictive analytics uses in health insurance. Analytics and informatics ...- Authors: Marilyn Medved McGaffin
- Date: Mar 2017
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Technology & Applications>Analytics and informatics
-
Modeling Anti-selective Lapse and Optimal Pricing in Individual and Small Group Health Insurance
Modeling Anti-selective Lapse and Optimal Pricing in Individual and Small Group Health Insurance A new health insurance pricing model takes external market prices into account, as well as ...- 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
-
Improving Medicare Advantage Star Ratings: An Analytical Framework
Improving Medicare Advantage Star Ratings: An Analytical Framework This paper outlines a framework for assisting a STARS manager in implementing a quantitative approach to prioritize stars ...- Authors: Puneet Budhiraja, Rajesh Munjuluri
- Date: Oct 2018
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability; Technology & Applications>Analytics and informatics
-
What We Have Learned in the Last50 Years—and Aren’t Using
What We Have Learned in the Last50 Years—and Aren’t Using This article reviews underwriting and why it has remained unchanged for 50 years. The unhealthy lifestyles of Americans are examined.- Authors: Chris E Stehno
- Date: May 2006
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Technology & Applications>Analytics and informatics
-
Building Actuarial Cost Models From Health Care Claims Data
Building Actuarial Cost Models From Health Care Claims Data Using Healthcare Claims Data to Create Actuarial Models. Business intelligence;Data mining=Big data;Managed care 6442476744 6/1/2017 12 ...- Authors: William Bednar
- Date: Jun 2017
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Influence decisions; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Technology & Applications>Analytics and informatics; Technology & Applications>Business intelligence
-
Health Risk Assessments in a Protected Environment
Health Risk Assessments in a Protected Environment A discussion of permissible use and collection of genetic information for Health Risk Assessments and wellness programs under the Genetic ...- Authors: John C Cameron
- Date: May 2010
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Professional Values>Ethical standards
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks; Public Policy; Technology & Applications>Analytics and informatics
-
Assessing Prescription Opioid Risk with Predictive Analytics
Assessing Prescription Opioid Risk with Predictive Analytics We highlight a new approach leveraging predictive analytics to identify high risk and rising risk opioid users for more effective ...- Authors: Joseph Boschert, Andrew Gaffner, Barbara Collier
- Date: Oct 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making; Strategic Insight and Integration>Influence decisions; 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: Demography>Population data; Experience Studies & Data; Health & Disability>Health information technology; Modeling & Statistical Methods>Data mining; Predictive Analytics; Technology & Applications>Analytics and informatics; Health & Disability>Electronic medical record
-
New Research Study Measurement of Health Care Quality and Efficiency: Resources for Health Care Professionals
New Research Study Measurement of Health Care Quality and Efficiency: Resources for Health Care Professionals Review of a research project, co-sponsored by the SOA, which examined 83 ...- Authors: Sara Teppema
- Date: Sep 2009
- Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Assess decision effectiveness; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health care quality; Modeling & Statistical Methods>Data mining; Technology & Applications>Analytics and informatics; Technology & Applications>Business intelligence
-
A Non-Traditional Actuarial Role
A Non-Traditional Actuarial Role Profile of an actuary in a non-traditional actuarial role: focusing on medical cost and analysis, both retrospective and prospective. Assumptions;Health care ...- Authors: Carolyn Young
- Date: May 2010
- Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Actuarial Profession>Alternative careers; Health & Disability>Health information technology; Modeling & Statistical Methods>Forecasting; Technology & Applications>Analytics and informatics