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  • Give Me Some Credibility: Addressing the Challenge of Volatility in Value-Based Contracts—Part 2

    Give Me Some Credibility: Addressing the Challenge of Volatility in Value-Based Contracts—Part 2 Discover the key components of value-based care (VBC) contracts and their impact on provider ...

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    • Authors: Maria Knox, James Pisko, Keith Passwater
    • Date: May 2023
    • Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
    • Publication Name: Health Watch
    • Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Predictive Analytics; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques

  • 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
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