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  • Calibrating Risk Score Model with Partial Credibility

    Calibrating Risk Score Model with Partial Credibility This article describes a method that can be useful when re-fitting a risk score model to a population of only moderate size. Learn how to use ...

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    • Authors: Sheamus Parkes, Bradley Armstrong
    • Date: Jul 2015
    • Competency: 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: Predictive Analytics and Futurism Newsletter
    • Topics: Health & Disability>Health care; Health & Disability>Health insurance; Modeling & Statistical Methods>Bayesian methods; Modeling & Statistical Methods>Data mining; Modeling & Statistical Methods>Estimation methods; Modeling & Statistical Methods>Regression analysis; Predictive Analytics
  • Reserving Challenges for Consumer-Directed Health Products

    Reserving Challenges for Consumer-Directed Health Products CDHP reserve levels claim, policy and premium reserves. New reserve technique for ASO plan sponsor reserves. Issue No. 48.

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    • Authors: Stephen J Kaczmarek
    • Date: Oct 2004
    • Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance
  • An Interview: Dr. Uwe Reinhardt

    An Interview: Dr. Uwe Reinhardt In this interview Dr. Reinhardt shares his thoughts on the role he believes actuaries should take in the health care system reforms. Assumptions;Episode-based ...

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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
  • New Member Impact on Medicaid Managed Care Costs

    New Member Impact on Medicaid Managed Care Costs In this article, the authors explore how the recession has impacted new member enrollment in the various state health care programs and the ...

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    • Authors: Bela H Patel Fernandez, Jeffrey L Smith
    • Date: Feb 2010
    • Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Economics>Health economics; Experience Studies & Data>Morbidity; Social Insurance>Government-funded healthcare; Social Insurance>Medicaid
  • Dental Coverage and the ACA

    Dental Coverage and the ACA This article discusses the challenges and unknowns relating to the regulatory inclusion of pediatric dental benefits within the essential benefits list of the ...

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    • Authors: Laurence R Weissbrot
    • Date: May 2012
    • 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 insurance; 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
  • Understanding ORSA: Risk, Solvency and Beyond

    Understanding ORSA: Risk, Solvency and Beyond Article is a detailed discussion of the Risk Management and Own Risk and Solvency Assessment (RMORSA) Model Act that was recently approved by the ...

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    • Authors: Elisabetta Russo, Lee H Resnick, Jacky Kwan
    • Date: Jan 2014
    • Competency: Strategic Insight and Integration>Strategy development; 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: Health Watch
    • Topics: Enterprise Risk Management>Risk appetite; Enterprise Risk Management>Risk categories; Enterprise Risk Management>Risk measurement - ERM; Finance & Investments>Risk measurement - Finance & Investments
  • Considerations for Surplus Determination under ACA

    Considerations for Surplus Determination under ACA Discussion of the impact of the ACA on RBS and required surplus for a health plan Risk-based capital=RBC;Patient Protection and Affordable Care ...

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    • Authors: Daniel Pribe, Richard Tash, David M Tuomala
    • Date: May 2014
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health insurance; Public Policy
  • 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
  • Medicare Advantage Star Ratings: Expectations for New Organizations

    Medicare Advantage Star Ratings: Expectations for New Organizations This article makes organizations entering the MA market aware of the star rating climate, as well as short- and long-term star ...

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    • Authors: Kelly Backes, Julia Friedman, Dustin Grzeskowiak, Elizabeth Phillips, Patricia Zenner
    • Date: Jun 2018
    • Competency: External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>Internal forces and business performance; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health insurance; Social Insurance>Medicare
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