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21 - 30 of 33 results (0.3 seconds)
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  • Modeling the Unwinding—Where Are We Now?

    Modeling the Unwinding—Where Are We Now? Article reviews the data a year into the unwinding of continuous coverage provisions in Medicaid, the impact on enrollment counts, how capitation rates ...

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    • Authors: Colby Schaeffer
    • Date: May 2024
    • Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
    • Publication Name: Health Watch
    • Topics: Health & Disability; Health & Disability>Health risks; Health & Disability>Public financing - Health & Disability

  • Pricing Issues Resulting from Budget Setting and Stoploss in ACO Arrangements

    Pricing Issues Resulting from Budget Setting and Stoploss in ACO Arrangements This article will consider several issues arising from ACO budgeting and pricing of stoploss coverage, including: 1) ...

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    • Authors: Anthony Rubiano
    • Date: May 2012
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health risks; Health & Disability>Payment models; Public Policy

  • Strategies for Leveraging the ACA Risk Adjuster

    Strategies for Leveraging the ACA Risk Adjuster This article begins with a comparison of the commercial risk adjuster to the exisiting Medicare model, and goes on to discuss why the existing ...

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    • Authors: Jason Siegel
    • Date: Oct 2013
    • Competency: Technical Skills & Analytical Problem Solving>Incorporate risk management
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks

  • Bariatric Surgery Holds Promise for Patients and for Payors

    Bariatric Surgery Holds Promise for Patients and for Payors An economic analysis of bariatric surgery and health care costs supports the case for health plans to cover these procedures. Health ...

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    • Authors: John Dawson, Pierre-Yves Cremieux, Arindam Ghosh
    • Date: Jan 2011
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Economics>Health economics; Experience Studies & Data; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining

  • The State of Predictive Analytics in U.S. Health care

    The State of Predictive Analytics in U.S. Health care Health care predictive analytics varies between payers and providers as well as being a powerful tool in business decision modeling. Data ...

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    • Authors: Marilyn Medved McGaffin
    • Date: Nov 2016
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health risks; Predictive Analytics

  • 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

  • Health Risk Assessments in a Protected Environment

    Health Risk Assessments in a Protected Environment A discussion of permissible use and collection of genetic information for Health Risk Assessments and wellness programs under the Genetic ...

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    • Authors: John C Cameron
    • Date: May 2010
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Professional Values>Ethical standards
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health risks; Public Policy; Technology & Applications>Analytics and informatics

  • A Simple Proposal to Save the Individual ACA Market

    A Simple Proposal to Save the Individual ACA Market We propose using premiums and tax revenue to fund high-cost individuals in the Individual ACA market. Patient Protection and Affordable Care ...

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    • Authors: Joseph Slater, John Culkin
    • Date: Feb 2018
    • Competency: Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Innovative solutions
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health risks; Public Policy

  • Risk Adjustment: The Details and Why They Matter

    Risk Adjustment: The Details and Why They Matter The CMS Risk adjustment model allows actuaries to apply our analytical skills and business knowledge to solve risk and revenue challenges within ...

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    • Authors: Karena Weikel
    • Date: Feb 2018
    • Competency: Technical Skills & Analytical Problem Solving
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health risks

  • Estimating the Impact of Disease and Treatment on Life Expectancy

    Estimating the Impact of Disease and Treatment on Life Expectancy Analysis of the impact of disease progression and treatment on life expectancy provides perspective on the long term costs to the ...

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    • Authors: Tzu-Chun Kuo, Philipp Vetter
    • Date: Jan 2011
    • Competency: Leadership>Thought leadership; Professional Values>Public interest representation; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Demography>Longevity; Health & Disability>Health care quality; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining
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