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Design and Pricing of Tiered Network Health Plans
Design and Pricing of Tiered Network Health Plans This article discusses the advantages, logistical concerns, and pricing formulas of implementing a TNHP, in which members pay less for treatment ...- 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
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Letter from the Editor
Letter from the Editor Recap of content contained in the January 2014 issue of the Health Watch newsletter. Health insurance;Health care costs;Medicaid;Patient Protection and Affordable Care Act ...- Authors: Kurt Wrobel
- Date: Jan 2014
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Professional Values>Practice expertise
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Public Policy
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Stop Loss Myths Debunked
Stop Loss Myths Debunked In this article, the author shares some opinions and observations derived from his experiences as a major reinsurer of stop loss in the early 80’s and as a rapidly ...- Authors: John K Ahrens
- Date: Sep 2008
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
- Publication Name: Health Watch
- Topics: Reinsurance>Stop-loss insurance
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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 ...- 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
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Advanced Business Analytics:Applied Statistics, Programming and Actuaries
Advanced Business Analytics:Applied Statistics, Programming and Actuaries Overview of opportunities for actuaries in business analytics, as well as the applied statistics and programming skills ...- Authors: Sheamus Parkes
- Date: Jan 2014
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations
- Publication Name: Health Watch
- Topics: Predictive Analytics
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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 ...- 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
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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 ...- 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
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Letter from the Editor
Letter from the Editor Recap of content contained in the May 2013 issue of the Health Watch newsletter. Accountable care organizations= ACO;Health insurance;Medicaid;Payment models=Health care ...- Authors: Kurt Wrobel
- Date: May 2013
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Professional Values>Practice expertise
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Public Policy
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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 ...- 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
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Rethinking Family Tiers
Rethinking Family Tiers A closer look at family tier factor rating assumptions, and how well they reflect actual claim cost data. Assumptions;Family coverage;Health care costs; 25712 1/1/2011 12: ...- Authors: Kristi Bohn
- 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: Modeling & Statistical Methods>Data mining; Technology & Applications>Analytics and informatics