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  • Immigration Reform and What It Could Mean for the Long-Term

    Immigration Reform and What It Could Mean for the Long-Term The article looks at potential changes in care provider demographics that could ultimately have an impact on the cost of long term care ...

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    • Authors: Brian Ulery
    • Date: Aug 2018
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Practice expertise; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Long-Term Care News
    • Topics: Demography>Population data; Experience Studies & Data>Long-term care - Experience Studies & Data; Health & Disability>Health care; Long-term Care>Long-term care insurance; Long-term Care>Long-term care facilities & home care

  • Validating a Novel Health Insurance Fraud Detection Method

    Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for ...

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    • Authors: Robert D Lieberthal, Elias
    • Date: Aug 2018
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Effective decision-making; 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: Risk Management
    • Topics: Economics>Health economics; Enterprise Risk Management; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Data mining; Predictive Analytics

  • 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
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