Welcome to Inspire from AHP!
We created the Inspire blog to have a positive impact on both the health care system and its clients.
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 [...]
Republican Health Care Reform and Its Impact on Health Insurers
Presidential Candidate Donald Trump promised to repeal and replace the Affordable Care Act (i.e., ACA or Obamacare). “On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal [...]
Medical IBNR; Traditional Approach with a New Twist
Medical claims reserving has remained relatively unchanged for decades. The traditional approach to calculating IBNR reserves, that will be defined later in this article, has stayed the same even though technology and computing power [...]
Annual ACA Check Up: Stabilizing the New Marketplaces
Recognized as a firm deeply engaged in the regulatory and technical aspects of the Patient Protection and Affordable Care Act (ACA), we were invited to provide comments and influence President Obama’s final regulatory enhancements [...]