Welcome to Inspire from AHP!
We created the Inspire blog to have a positive impact on both the health care system and its clients.
The Forgotten and Undervalued Resource: Care Management
In many of our recent client situations we encounter a surprising lack of awareness and concern about the importance of care management and how it might directly impact the project we are working on. [...]
Saving the Exchanges? A Case for the Provider-Owned Health Plan
Introduction There is a lot of talk about the future of Obamacare. Many fear the exchanges are in a death spiral and, if left to current market forces, will eventually implode. Guaranteed issue laws [...]
The 24-Lever Model: Lowering Insurance Premiums
This issue of Inspire is the first in a series of Inspire issues devoted to the 24-lever model. Introduction It is a story the health plan actuary knows all too well: The marketing and [...]
Data Intermediaries: Pulling Insights from Confidential Data
Over the past several years, I have had the privilege of providing actuarial support to health systems pursuing alternative payment models and value-based reimbursement arrangements. In some cases, the health system was approached by [...]
Assessing ACO Performance
As more health plans utilize Accountable Care Organizations (i.e., ACOs) as part of their network operations, ACO performance assessment is becoming more important. Plans should thoroughly assess an ACO before they agree to contracting. [...]
Case Study in Problem Solving: The Case of the Uncompetitive ACO
I love a good challenge—particularly one that doesn’t have a clear path forward and seems daunting from the outset. Recently, a large health plan client presented us with just such a challenge: they had [...]