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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
  • 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 ...

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    • 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
  • 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 ...

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    • 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
  • 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 ...

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    • 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
  • Health Watch, June 2017, Issue 83
    Health Watch, June 2017, Issue 83 Read the June 2017 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

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    • Authors: Society of Actuaries
    • Date: Jun 2017
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • 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 ...

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    • 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
  • Health Watch, Issue 79, December 2015, Health Watch
    Health Watch, Issue 79, December 2015, Health Watch Health Watch, Issue 79, December 2015, Health Watch Critical illness insurance;Ethics;Health reserves;Health Research;Cause-of-death mortality; ...

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    • Authors: Society of Actuaries
    • Date: Dec 2015
    • Competency: Communication>Written communication; External Forces & Industry Knowledge; Leadership>Influence; Professional Values>Ethical standards; Relationship Management>Team leadership; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; 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: Experience Studies & Data>Disability; Health & Disability>Critical illness insurance; Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks; Modeling & Statistical Methods>Modeling efficiency; Modeling & Statistical Methods>Regression analysis; Technology & Applications>Computer science
  • ASOPs, Anti- Selection, Affordability and ACA Altern
    ASOPs, Anti- Selection, Affordability and ACA Altern This article is focused on sustainability concerns in the ACA individual markets and what we can learn from core actuarial principles as ...

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    • Authors: Gregory Fann
    • Date: Nov 2016
    • Competency: Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Big picture view
    • Publication Name: Health Watch
    • Topics: Actuarial Profession>Standards of practice; Health & Disability>Health care; Health & Disability>Health risks; Public Policy; Public Policy
  • Medicare Advantage Hierarchical Condition Categories: Updated Study Results
    Medicare Advantage Hierarchical Condition Categories: Updated Study Results Summary and analysis of the diseases and conditions exhibited in the Medicare Advantage population Medicare;Risk ...

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    • Authors: Corey Berger, Eric P Goetsch
    • Date: Jan 2013
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health risks; Social Insurance>Medicare
  • New Managed Care Risk-Based Capital
    New Managed Care Risk-Based Capital Managed Care Risk-Based Capital new formula for HMOs and BCBS plans, modification of disability income, LTC and stop loss factors, market uses of RBC, company ...

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    • Authors: Donna C Novak
    • Date: Apr 2000
    • Competency: External Forces & Industry Knowledge>Internal forces and business performance
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health risks