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Transparency Leads Actuarial Survey of Trend-Benders
Transparency Leads Actuarial Survey of Trend-Benders Summary of results of a 2010 Health Section survey of actuaries and Medicare population, on ways to bend the cost trend curve downward.- Authors: Sara Teppema
- Date: Sep 2010
- Competency: Communication; Leadership>Professional network leverage; Leadership>Thought leadership; Strategic Insight and Integration>Strategy development
- Publication Name: Health Watch
- Topics: Health & Disability>Health care quality; Public Policy; Public Policy
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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 ...- 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
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An Interview with Susan Dentzer
An Interview with Susan Dentzer Susan Dentzer, editor-in-chief of Health Affairs, discusses health care and health policy. Patient Protection and Affordable Care Act= PPACA=Affordable Care Act; ...- Authors: Mary Kindel Van der Heijde, Douglas Norris
- Date: Oct 2011
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Actuarial Profession>Academic partnerships; Health & Disability>Health care
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Massachusetts Payment Reform from an Actuarial Perspective
Massachusetts Payment Reform from an Actuarial Perspective The article is a case study of various actuarial concepts invovled in the design and implementtion of the AQC - a global budget provider ...- Authors: Matthew Day, Jill Wilson
- Date: May 2013
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Payment models; Public Policy
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Health Watch Issue 73, October 2013
Health Watch Issue 73, October 2013 The entire issue of Health Watch. Health care costs;Health care quality;Health care reform;Medicaid;Medicare 6442451562 10/1/2013 12:00:00 AM ...- Authors: Karen Perry, Society of Actuaries
- Date: Oct 2013
- Competency: Results-Oriented Solutions>Actionable recommendations
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
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Simple and Effective Reserve Practices
Simple and Effective Reserve Practices When setting reserves, multiple methods are often used in the creation of the reserve estimate. Judgment is warranted to combine these different estimates ...- Authors: Christopher Coulter, Dale Cap, Kevin McCoy
- Date: Dec 2015
- 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 insurance; Modeling & Statistical Methods>Modeling efficiency; Modeling & Statistical Methods>Regression analysis; Technology & Applications>Computer science
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Examining the Evidence - Enhanced Primary Care Leads to Reduced Hospital Use and Saves Costs - Or Does It?
Examining the Evidence - Enhanced Primary Care Leads to Reduced Hospital Use and Saves Costs - Or Does It? Article describes enhanced primary care models and provides citations on whether or not ...- Authors: Tia Sawhney, Bruce Pyenson
- Date: Jan 2015
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health risks; Health & Disability>Payment models
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Section 1332 Waivers: Coming Soon to a State Near You?
Section 1332 Waivers: Coming Soon to a State Near You? This article discusses new opportunities for states to waive certain marketplace requirements of the Patient Protection and Affordable Care ...- Authors: Gregory Fann
- Date: May 2016
- Competency: Strategic Insight and Integration>Strategy development
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability; Public Policy; Public Policy
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Managing Population Health
Managing Population Health This article defines population health and discusses what is needed to manage population health under value based contracts. Population Health 6442468674 5/1/2016 12:00 ...- Authors: Daniel Pribe
- Date: May 2016
- Competency: Strategic Insight and Integration>Strategy development
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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Leader Interview
Leader Interview This article is an interview with an actuarial leader. Professional development=PD;Career planning;Presentation skills=Public speaking 6442475084 3/1/2017 12:00:00 AM ...- Authors: Gregory Fann
- Date: Mar 2017
- Competency: Leadership>Change management; Leadership>Influence; Leadership>Mentoring
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional development; Health & Disability>Health insurance