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Considerations for Surplus Determination under ACA
Considerations for Surplus Determination under ACA Discussion of the impact of the ACA on RBS and required surplus for a health plan Risk-based capital=RBC;Patient Protection and Affordable Care ...- Authors: Daniel Pribe, Richard Tash, David M Tuomala
- Date: May 2014
- Competency: External Forces & Industry Knowledge>External forces and business performance; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Public Policy
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Pricing Issues Resulting from Budget Setting and Stoploss in ACO Arrangements
Pricing Issues Resulting from Budget Setting and Stoploss in ACO Arrangements This article will consider several issues arising from ACO budgeting and pricing of stoploss coverage, including: 1) ...- Authors: Anthony Rubiano
- Date: May 2012
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Health & Disability>Health risks; Health & Disability>Payment models; Public Policy
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Medicare Advantage Star Ratings: Expectations for New Organizations
Medicare Advantage Star Ratings: Expectations for New Organizations This article makes organizations entering the MA market aware of the star rating climate, as well as short- and long-term star ...- Authors: Kelly Backes, Julia Friedman, Dustin Grzeskowiak, Elizabeth Phillips, Patricia Zenner
- Date: Jun 2018
- Competency: External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>Internal forces and business performance; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health insurance; Social Insurance>Medicare
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ERM Opportunities for Health Practitioners
ERM Opportunities for Health Practitioners Summary of recent SOA-sponsored research on Enterprise Risk Management practices as applied to health insurers, self-insured plans, and health finance ...- Authors: Max Rudolph
- Date: May 2010
- Competency: Communication; External Forces & Industry Knowledge>External forces and business performance; Leadership>Change management; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Actuarial Profession>Alternative careers; Actuarial Profession>Best practices; Enterprise Risk Management; Enterprise Risk Management>Compliance
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New Research Study Measurement of Health Care Quality and Efficiency: Resources for Health Care Professionals
New Research Study Measurement of Health Care Quality and Efficiency: Resources for Health Care Professionals Review of a research project, co-sponsored by the SOA, which examined 83 ...- Authors: Sara Teppema
- Date: Sep 2009
- Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Assess decision effectiveness; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health care quality; Modeling & Statistical Methods>Data mining; Technology & Applications>Analytics and informatics; Technology & Applications>Business intelligence
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The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries
The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries Explanation of Medicare Advantage STAR rating program as it relates to payment rates for MA bids. Also describes ...- Authors: Adrian L Clark, Gabriela Dieguez, Bradley James Piper
- Date: May 2012
- Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy