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Implications of Individual Subsidies in the Affordable Care Act—What Stakeholders Need to Understand
Implications of Individual Subsidies in the Affordable Care Act—What Stakeholders Need to Understand This article provides a detailed description of the unbalanced subsidy provisions in the ...- Authors: Gregory Fann
- Date: May 2014
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Results-Oriented Solutions>Assess decision effectiveness; Strategic Insight and Integration>Effective decision-making
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability
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Implementing Parity: Investing in Behavioral Health – Part 2
Implementing Parity: Investing in Behavioral Health – Part 2 Part 1 of a 2-part series exploring implementation issues for the Mental Health Parity and Addiction Equity Act of 2008 MHPAEA. Part ...- Authors: Stephen P Melek
- Date: Sep 2010
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration>Effective decision-making
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Public Policy
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Design and Pricing of Tiered Network Health Plans
Design and Pricing of Tiered Network Health Plans This article discusses the advantages, logistical concerns, and pricing formulas of implementing a TNHP, in which members pay less for treatment ...- Authors: Peter Horman
- Date: May 2009
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Economics>Health economics; Health & Disability>Health care quality; Modeling & Statistical Methods
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An Interview: Dr. Uwe Reinhardt
An Interview: Dr. Uwe Reinhardt In this interview Dr. Reinhardt shares his thoughts on the role he believes actuaries should take in the health care system reforms. Assumptions;Episode-based ...- Authors: Mary Kindel Van der Heijde, Douglas Norris
- Date: Sep 2009
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Leadership>Thought leadership; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Actuarial Profession>Traditional careers; Enterprise Risk Management; Health & Disability>Health risks; Health & Disability>Payment models
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Behind Clinical Integration
Behind Clinical Integration Recent health care reform activity has highlighted the importance of Clinical Integration in improving the quality, safety, efficiency and reimbursement infrastructure ...- Authors: Steven Tutewohl
- Date: May 2010
- Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Public interest representation; Strategic Insight and Integration>Effective decision-making
- Publication Name: Health Watch
- Topics: Health & Disability>Health information technology; Public Policy; Technology & Applications>Data warehousing; Health & Disability>Electronic medical record
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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
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Palliative Care
Palliative Care This article from major US payers describes palliative care as a scaleable means of improving quality and reducing costs during serious and complex illness. Payment models=Health ...- Authors: Randall Krakauer, Bruce Smith, Diane Meier, Torrie Fields
- Date: Nov 2016
- Competency: Leadership>Change management; Leadership>Influence; Leadership>Mentoring; Leadership>Professional network leverage; Leadership>Thought leadership; Results-Oriented Solutions>Actionable recommendations; Results-Oriented Solutions>Assess decision effectiveness; Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Effective decision-making
- Publication Name: Health Watch
- Topics: Economics>Health economics; Enterprise Risk Management>Systematic risk; Experience Studies & Data>Morbidity; Experience Studies & Data>Mortality; Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care quality; Health & Disability>Payment models
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Commercial Health Care: What’s Next? A Health Section Strategic Initiative
Commercial Health Care: What’s Next? A Health Section Strategic Initiative The Health Section's strategic initiative entitled Commercial Health Care: What’s Next? focuses on health care ...- Authors: David Dillon
- Date: Oct 2018
- Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Public Policy; Public Policy