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  • New Member Impact on Medicaid Managed Care Costs

    New Member Impact on Medicaid Managed Care Costs In this article, the authors explore how the recession has impacted new member enrollment in the various state health care programs and the ...

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    • Authors: Bela H Patel Fernandez, Jeffrey L Smith
    • Date: Feb 2010
    • Competency: Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Economics>Health economics; Experience Studies & Data>Morbidity; Social Insurance>Government-funded healthcare; Social Insurance>Medicaid
  • 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
  • From The Editor

    From The Editor A look into the issues’ contents. By Carlos Fuentes Models;Strategy;Artificial intelligence;Passion;Product development;Predictive modeling;Entrepreneurship By Carlos Fuentes What ...
    • Authors: Carlos Eduardo Fuentes
    • Date: Nov 2017
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>General business skills; Leadership>Thought leadership; Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Innovators & Entrepreneurs
    • Topics: Actuarial Profession>Management skills; Economics>Health economics; Economics>Macroeconomics; Modeling & Statistical Methods>Estimation methods
  • Projected Cost Analysis of Potential Medicare Pharmacy Plan Designs

    Projected Cost Analysis of Potential Medicare Pharmacy Plan Designs Research report sponsored by SOA to model and compare projected costs of different proposals for a Medicare prescription drug ...

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    • Authors: Lynette Trygstad, Timothy Feeser, Corey Berger
    • Date: Jul 2003
    • Competency: External Forces & Industry Knowledge; Leadership>Change management; Professional Values>Public interest representation; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Influence decisions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Topics: Economics>Health economics; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Forecasting; Public Policy; Social Insurance>Medicare; Technology & Applications>Analytics and informatics
  • Review: “Health Insurance for ‘Humans’: Information Friction

    Review: “Health Insurance for ‘Humans’: Information Friction A review of the academic article "Health Insurance for ‘Humans’: Information Frictions, Plan Choice, and Consumer ...

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    • Authors: Christopher Coulter, Kathleen Dobrzynski, Tyler Engel, Dorothy Andrews
    • Date: Nov 2016
    • Competency: Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Economics>Behavioral economics; Economics>Health economics; Health & Disability>Health care
  • 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 ...

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    • 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
  • Human Nature and the US Health Care System, Part I

    Human Nature and the US Health Care System, Part I The third in a series of four articles that illustrate the “soft” approach of game theory using Thucydides’ master work, The History of the ...
    • Authors: Carlos Eduardo Fuentes
    • Date: Feb 2018
    • Competency: External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>General business skills; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Innovators & Entrepreneurs
    • Topics: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health insurance
  • Financial Decision-Making Theory and the Small Employer Health Insurance Market in Texas

    Financial Decision-Making Theory and the Small Employer Health Insurance Market in Texas This paper describes in detail each of five options available to small Texas employers wanting to purchase ...

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    • Authors: Bonnie Albritton
    • Date: Oct 2006
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Actuarial Practice Forum
    • Topics: Economics>Health economics; Health & Disability>Health insurance