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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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How blockchain technology will disrupt the PBM-payer-pharmacy relationship
How blockchain technology will disrupt the PBM-payer-pharmacy relationship This article explores the disruptive applications of blockchain, an emerging technology, and its impact on the pharmacy ...- Authors: Brian Anderson, Michael DiPrima , Greg Callahan
- Date: Apr 2020
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Technology & Applications; Technology & Applications>Blockchain & cryptocurrency
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An Executive Roundtable on the State of Predictive Analytics in U.S. Health Care
An Executive Roundtable on the State of Predictive Analytics in U.S. Health Care Many executives are talking about predictive analytics uses in health insurance. Analytics and informatics ...- Authors: Marilyn Medved McGaffin
- Date: Mar 2017
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Technology & Applications>Analytics and informatics
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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 ...- 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
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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; ...- 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
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Digital Health
Digital Health This article is a brief overview of what digital health is, how it is regulated, and who some of the big unicorns are. 2/24/2020 12:00:00 AM ...- Authors: Marilyn Medved McGaffin
- Date: Feb 2020
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Technology & Applications; Technology & Applications>Analytics and informatics; Technology & Applications>Cyber risk; Technology & Applications>Telematics; Technology & Applications>Wearables & implants
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Cost and Benefit Trends Observed in Jan. 1, 2011 Renewals for State Employers
Cost and Benefit Trends Observed in Jan. 1, 2011 Renewals for State Employers An analysis of health insurance cost and benefit trends using January 1, 2011 data from state employee medical plan ...- Authors: Robert Gordon Cosway, Barbara Dewey
- Date: Jan 2011
- Competency: External Forces & Industry Knowledge>Internal forces and business performance; Professional Values>Public interest representation
- Publication Name: Health Watch
- Topics: Economics>Health economics; Experience Studies & Data; Technology & Applications>Analytics and informatics
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What We Have Learned in the Last50 Years—and Aren’t Using
What We Have Learned in the Last50 Years—and Aren’t Using This article reviews underwriting and why it has remained unchanged for 50 years. The unhealthy lifestyles of Americans are examined.- Authors: Chris E Stehno
- Date: May 2006
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Technology & Applications>Analytics and informatics
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Building Actuarial Cost Models From Health Care Claims Data
Building Actuarial Cost Models From Health Care Claims Data Using Healthcare Claims Data to Create Actuarial Models. Business intelligence;Data mining=Big data;Managed care 6442476744 6/1/2017 12 ...- Authors: William Bednar
- Date: Jun 2017
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Influence decisions; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Technology & Applications>Analytics and informatics; Technology & Applications>Business intelligence
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Operational Considerations in Predictive Modeling
Operational Considerations in Predictive Modeling This article summarizes some of the operational considerations necessary to optimize the usefulness and impact of a predictive model, such as ...- Authors: Christine Hofbeck
- Date: May 2014
- Competency: Results-Oriented Solutions>Actionable recommendations; Results-Oriented Solutions>Assess decision effectiveness
- Publication Name: Health Watch
- Topics: Technology & Applications>Analytics and informatics; Technology & Applications>Business intelligence