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  • Bundled Reimbursement: A Step in the Right Direction, or Another Flawed Idea?

    Bundled Reimbursement: A Step in the Right Direction, or Another Flawed Idea? An overview of the issues behind reimbursing providers on a bundled or packaged basis. The article presents the ...

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    • Authors: Todd Lueders
    • Date: Sep 2010
    • Competency: External Forces & Industry Knowledge; Professional Values>Public interest representation; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view
    • Publication Name: Health Watch
    • Topics: Economics>Health economics; Health & Disability>Health care quality; Public Policy; Public Policy
  • Do Individuals Make Sensible Health Insurance Decisions

    Do Individuals Make Sensible Health Insurance Decisions New research shows that we often make sub-optimal choices, when selecting a health insurance plan, that lead to unnecessary out-of-pocket ...

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    • Authors: Alexander Leung, Jonah Yearick, Randy P Herman
    • Date: Nov 2016
    • Competency: External Forces & Industry Knowledge; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development
    • Publication Name: Health Watch
    • Topics: Economics>Behavioral economics; Economics>Health economics; Health & Disability>Health insurance; Technology & Applications>E-commerce
  • Palliative Care

    Palliative Care This article from major US payers describes palliative care as a scaleable means of improving quality and reducing costs during serious and complex illness. Payment models=Health ...

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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
  • Selling Health Insurance Across State Lines

    Selling Health Insurance Across State Lines Discusses various aspects of allowing a health insurance policy approved in one state to be sold in another state without the latter's approval ...

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    • Authors: Lawrence Mitchell
    • Date: Jun 2017
    • Competency: External Forces & Industry Knowledge>Internal forces and business performance; Professional Values>Public interest representation; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Influence decisions
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care
  • Navigating Cost-Sharing Reduction Subsidy Defunding

    Navigating Cost-Sharing Reduction Subsidy Defunding This paper will examine why CSR defunding produces pricing uncertainty and how regulators can alleviate these risks when insurers price 2020 ...

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    • Authors: Michael Cohen, Peter van Laarhoven
    • Date: Mar 2019
    • Competency: Professional Values>Practice expertise; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance; Public Policy
  • The U.S. Health Care Revolution: Give Me an Incentivized Provider Payment System or Give Me Death!

    The U.S. Health Care Revolution: Give Me an Incentivized Provider Payment System or Give Me Death! A proposal to reform the health care provider payment system through: a national fee schedule, ...

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    • Authors: John Dante
    • Date: Sep 2010
    • Competency: Leadership>Thought leadership; Professional Values>Public interest representation; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Influence decisions
    • Publication Name: Health Watch
    • Topics: Economics>Health economics; Health & Disability>Health care quality; Health & Disability>Payment models; Public Policy; Public Policy
  • The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries

    The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries Explanation of Medicare Advantage STAR rating program as it relates to payment rates for MA bids. Also describes ...

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    • Authors: Adrian L Clark, Gabriela Dieguez, Bradley James Piper
    • Date: May 2012
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy
  • Recommendations for a Successful ACA Rate Filing

    Recommendations for a Successful ACA Rate Filing Summary of common mistakes made by actuaries developing ACA rate filings. Outlines correct approach to ACA rate filing process. Suggests Peer ...

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    • Authors: Joseph Slater
    • Date: Nov 2016
    • Competency: Communication>Difficult message delivery; Communication>Oral communication; Communication>Persuasive communication; Communication>Written communication; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Actuarial Profession>Best practices; Health & Disability>Health insurance; Public Policy