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  • Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews

    Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the ...

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    • Authors: Corey Berger, Eric P Goetsch
    • Date: Jan 2011
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving
    • Publication Name: Health Watch
    • Topics: Demography; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining; Social Insurance>Medicare; Technology & Applications>Analytics and informatics

  • Examining the Evidence - Enhanced Primary Care Leads to Reduced Hospital Use and Saves Costs - Or Does It?

    Examining the Evidence - Enhanced Primary Care Leads to Reduced Hospital Use and Saves Costs - Or Does It? Article describes enhanced primary care models and provides citations on whether or not ...

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    • Authors: Tia Sawhney, Bruce Pyenson
    • Date: Jan 2015
    • Competency: External Forces & Industry Knowledge
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health risks; Health & Disability>Payment models

  • Section 1332 Waivers: Coming Soon to a State Near You?

    Section 1332 Waivers: Coming Soon to a State Near You? This article discusses new opportunities for states to waive certain marketplace requirements of the Patient Protection and Affordable Care ...

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    • Authors: Gregory Fann
    • Date: May 2016
    • Competency: Strategic Insight and Integration>Strategy development
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability; Public Policy; Public Policy

  • Why so Many People Have Untreated Mental Health Conditions

    Why so Many People Have Untreated Mental Health Conditions The article reviews high-deductible health plans and poor reimbursement for mental health providers as being the root of 3 devastating ...

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    • Authors: Dawn Motovidlak
    • Date: Jun 2018
    • Competency: Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models

  • Soundbites from the American Academy of Actuaries’ Health Practice Council

    Soundbites from the American Academy of Actuaries’ Health Practice Council Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate health care ...

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    • Authors: Heather E Jerbi, Melissa Stevens
    • Date: Sep 2009
    • Competency: Communication>Written communication; Leadership>Influence; Professional Values>Public interest representation; Strategic Insight and Integration>Influence decisions
    • Publication Name: Health Watch
    • Topics: Actuarial Profession>Professional associations; Health & Disability>Health risks; Public Policy; Public Policy; Social Insurance>Medicare

  • Health Watch, June 2017, Issue 83

    Health Watch, June 2017, Issue 83 Read the June 2017 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

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    • Authors: Society of Actuaries
    • Date: Jun 2017
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability

  • Commercial Health Care: What’s Next?

    Commercial Health Care: What’s Next? This article contains a condensed summary and excerpt from the fourth white paper in the Commercial Health Care: What’s Next? series. health care reform;risk ...

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    • Authors: David Dillon
    • Date: Feb 2018
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; Leadership>Thought leadership
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health care; Health & Disability>Health risks; Public Policy; Public Policy

  • Modeling Anti-selective Lapse and Optimal Pricing in Individual and Small Group Health Insurance

    Modeling Anti-selective Lapse and Optimal Pricing in Individual and Small Group Health Insurance A new health insurance pricing model takes external market prices into account, as well as ...

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    • Authors: D Wei
    • Date: Feb 2010
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Incorporate risk management
    • Publication Name: Health Watch
    • Topics: Economics>Health economics; Health & Disability>Health risks; Modeling & Statistical Methods; Technology & Applications>Analytics and informatics

  • Medicare Advantage Hierarchical Condition Categories: Updated Study Results

    Medicare Advantage Hierarchical Condition Categories: Updated Study Results Summary and analysis of the diseases and conditions exhibited in the Medicare Advantage population Medicare;Risk ...

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    • Authors: Corey Berger, Eric P Goetsch
    • Date: Jan 2013
    • Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Technical Skills & Analytical Problem Solving>Problem analysis and definition
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health risks; Social Insurance>Medicare

  • Health Watch, Issue 79, December 2015, Health Watch

    Health Watch, Issue 79, December 2015, Health Watch Health Watch, Issue 79, December 2015, Health Watch Critical illness insurance;Ethics;Health reserves;Health Research;Cause-of-death mortality; ...

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    • Authors: Society of Actuaries
    • Date: Dec 2015
    • Competency: Communication>Written communication; External Forces & Industry Knowledge; Leadership>Influence; Professional Values>Ethical standards; Relationship Management>Team leadership; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; 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: Experience Studies & Data>Disability; Health & Disability>Critical illness insurance; Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks; Modeling & Statistical Methods>Modeling efficiency; Modeling & Statistical Methods>Regression analysis; Technology & Applications>Computer science
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