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  • Palliative Care
    Palliative Care This article from major US payers describes palliative care as a scaleable means of ... Payment models=Health care payment models;Health care costs;Managed care;Home health care 6442471996 11/1/2016 ...

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    • 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
  • 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 ... unbalanced subsidy provisions in the Affordable Care Act with easy to follow numerical illustrations ...

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    • 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
  • 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 ... initiative entitled Commercial Health Care: What’s Next? focuses on health care reform. This article contains ...

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    • 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
  • An Interview: Dr. Uwe Reinhardt
    take in the health care system reforms. Assumptions;Episode-based payment;Health care costs;Health factors;Medical ... factors;Medical expenses;Payment reforms=Health care payment reforms;Risk adjustment; 9515 9/1/2009 12:00:00 ...

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    • 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
  • Behind Clinical Integration
    Behind Clinical Integration Recent health care reform activity has highlighted the importance of Clinical ... efficiency and reimbursement infrastructure of the health care system. This article discusses relevance and implication ...

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    • 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
  • Assessing Prescription Opioid Risk with Predictive Analytics
    Assessing Prescription Opioid Risk with Predictive Analytics We highlight a new approach leveraging ... users for more effective screening and follow-up care. Predictive modeling;Health risks;Data mining=Big ...

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    • 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
  • Design and Pricing of Tiered Network Health Plans
    Design and Pricing of Tiered Network Health Plans This article discusses the advantages, logistical ... quality and cost-effectiveness standards. Accountable care organizations= ACO;Assumptions;Behavioral econo ...

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    • 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
  • Implementing Parity: Investing in Behavioral Health – Part 2
    Implementing Parity: Investing in Behavioral Health – Part 2 Part 1 of a 2-part series ... regulations could impact the business of behavioral health care and the impending decisions for payors, employers ...

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    • 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
  • New Behavioral Finance Subgroup
    incentives to influence behavior. The rise of managed care marked a period of insurers overtly attempting ... influencing behaviors. One example of this was using primary care physicians (PCPs) as gatekeepers and using ...

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    • Authors: John Stark
    • Date: Jan 2013
    • Competency: Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Innovative solutions
    • Publication Name: Health Watch
    • Topics: Economics>Behavioral economics
  • What does ERM mean for Health Practitioners?
    Why Care About Enterprise Risk Management? I n late 2008, the health insurance industry faced a number ... Garnett 10 New Member Impact on Medicaid Managed Care Costs By Bela Patel Fernandez and Jeff Smith ...

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    • Authors: Max Rudolph
    • Date: Feb 2010
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Relationship Management>Staff management and motivation; Results-Oriented Solutions; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management
    • Publication Name: Health Watch
    • Topics: Economics>Health economics; Enterprise Risk Management; Modeling & Statistical Methods>Forecasting