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  • 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 ...

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    • 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
  • Retirees versus Active Workers: What is the Cost Difference?
    Retirees versus Active Workers: What is the Cost Difference? Comparison of healthcare costs for early retirees versus active workers in the same age band. When adjusted for age, there is not a ...

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    • Authors: Kristi Bohn, Sarah Legatt
    • Date: May 2011
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Demography>Population data; Modeling & Statistical Methods>Data mining
  • Bariatric Surgery Holds Promise for Patients and for Payors
    Bariatric Surgery Holds Promise for Patients and for Payors An economic analysis of bariatric surgery and health care costs supports the case for health plans to cover these procedures. Health ...

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    • Authors: John Dawson, Pierre-Yves Cremieux, Arindam Ghosh
    • Date: Jan 2011
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Economics>Health economics; Experience Studies & Data; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining
  • Rethinking Family Tiers
    Rethinking Family Tiers A closer look at family tier factor rating assumptions, and how well they reflect actual claim cost data. Assumptions;Family coverage;Health care costs; 25712 1/1/2011 12: ...

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    • Authors: Kristi Bohn
    • Date: Jan 2011
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Modeling & Statistical Methods>Data mining; Technology & Applications>Analytics and informatics
  • 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 ...

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    • 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
  • Estimating the Impact of Disease and Treatment on Life Expectancy
    Estimating the Impact of Disease and Treatment on Life Expectancy Analysis of the impact of disease progression and treatment on life expectancy provides perspective on the long term costs to the ...

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    • Authors: Tzu-Chun Kuo, Philipp Vetter
    • Date: Jan 2011
    • Competency: Leadership>Thought leadership; Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Demography>Longevity; Health & Disability>Health care quality; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining