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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
  • Working With Health Care Coalitions
    With Health Care Coalitions Panel discussion about ways can insurance carriers and health care coalitions ... processing;Data warehousing;Health care costs;Health care quality;Long-term care=LTC;Policyholder behavior; ...

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    • Authors: Andrea B Castell, James P Hilferty, William H Rosenberg, Charles J Sherfey, Jean M Wodarczyk, Joseph H Rosmann
    • Date: Oct 1986
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Leadership>Professional network leverage; Professional Values>Public interest representation; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Record of the Society of Actuaries
    • Topics: Economics>Health economics; Health & Disability>Health information technology; Technology & Applications>Analytics and informatics
  • Defining Best-In-Market Health Opportunities
    health plans=CDHP;Group health plans;Health care costs;Health care quality;Health economics;Health insurance;Health ... insurance;Health maintenance organization=HMO ;Managed care;Preferred provider organization=PPO;Prescription ...

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    • Authors: Dale Yamamoto, Mindy S Kairey
    • Date: Jun 1998
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Innovative solutions
    • Publication Name: Record of the Society of Actuaries
    • Topics: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance
  • Validating a Novel Health Insurance Fraud Detection Method
    Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies ... Health care fraud;Predictive modeling;Medicare;Health insurance;Health economics;Health care costs;Data ...

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    • Authors: Robert D Lieberthal, Elias
    • Date: Aug 2018
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; 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: Risk Management
    • Topics: Economics>Health economics; Enterprise Risk Management; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Data mining; Predictive Analytics
  • 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
  • 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
  • Long-Term Disability Buyouts
    total removal of the business, with the name of the direct writer no longer on the contract, there's an immediate ... auditors told us. One of the other advantages to the direct writer is freeing up capital. The risk- based capital ...

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    • Authors: Michael Gabon, Stephen Mitchell, Daniel D Skwire
    • Date: Oct 2000
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making
    • Publication Name: Record of the Society of Actuaries
    • Topics: Economics>Health economics; Health & Disability>Disability insurance; Modeling & Statistical Methods>Stochastic models; Reinsurance>Reserving - Reinsurance