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Applying Diagnosis-Based Predictive Models to Group Underwriting
Applying Diagnosis-Based Predictive Models to Group Underwriting Applying Diagnosis-Based Predictive Models that use medical and pharmacy claims to measure expected costs for Group Underwriting.- Authors: Randall P Ellis, Marilyn Kramer
- Date: Aug 2003
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability
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Assessing Prescription Opioid Risk with Predictive Analytics
Assessing Prescription Opioid Risk with Predictive Analytics We highlight a new approach leveraging predictive analytics to identify high risk and rising risk opioid users for more effective ...- Authors: Joseph Boschert, Andrew Gaffner, Barbara Collier
- Date: Oct 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making; Strategic Insight and Integration>Influence decisions; 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: Demography>Population data; Experience Studies & Data; Health & Disability>Health information technology; Modeling & Statistical Methods>Data mining; Predictive Analytics; Technology & Applications>Analytics and informatics; Health & Disability>Electronic medical record
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ASOP No. 6 Exposure Draft Provisions Relating to Community-Rated HMO Contracts
ASOP No. 6 Exposure Draft Provisions Relating to Community-Rated HMO Contracts ASOP No. 6 Exposure Draft Provisions Relating to Community- Rated HMO Contracts. Discusses determination of initial ...- Authors: Application Administrator
- Date: Jan 2002
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Actuarial Profession>Standards of practice
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From Art to Science - Using Clinical Insight Modeling to Strengthen Actuarial Prediction
From Art to Science - Using Clinical Insight Modeling to Strengthen Actuarial Prediction Clinical Insight Modeling MST and RAI models development of predictive modeling software, utilization of ...- Authors: Harry Poteat
- Date: Jan 2002
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
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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 ...- 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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Over the Counter Drugs, theNew Tier Zero in Your PharmacyBenefit Plan
Over the Counter Drugs, theNew Tier Zero in Your PharmacyBenefit Plan With many pharmacy benefit plans now considering whether to add a 4th tier for high priced specialty drugs, review and ...- Authors: Steven D Berna
- Date: Sep 2006
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health care
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Medicare Advantage experience data: pitfalls and concerns beyond ASOP #23
Medicare Advantage experience data: pitfalls and concerns beyond ASOP #23 Medicare Advantage Organizations must consider influences both internal and external to the adjudication process as they ...- Authors: Michelle Wahab, Shelby Weber
- Date: Mar 2019
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health information technology; Social Insurance>Medicare; Technology & Applications>Data warehousing
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Adjusting the 1985 NAIC Cancer Claim Cost Tables for Inflation
Adjusting the 1985 NAIC Cancer Claim Cost Tables for Inflation Adjusting the 1985 NAIC Cancer Claim Cost Tables, a collection of morbidity tables, for Inflation and benefit changes Issue No. 34.- Authors: Peter G Hendee
- Date: Feb 1998
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Experience Studies & Data>Morbidity
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Combining an Actuarial and an Underwriting Approach
Combining an Actuarial and an Underwriting Approach Combining an Actuarial and an Underwriting Approach, Issue No. 39. Underwriting; 9364 12/1/2000 12:00:00 AM ...- Authors: David L Reichlinger
- Date: Dec 2000
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability
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Estimating IBNR from Authorized Bed Days
Estimating IBNR from Authorized Bed Days Estimating IBNR from Authorized Bed Days. Issue No. 40. Health reserves; 9384 4/1/2001 12:00:00 AM ...- Authors: Kevin L Pedlow
- Date: Apr 2001
- Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health care