Welcome to Inspire from AHP!
We created the Inspire blog to have a positive impact on both the health care system and its clients.
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 [...]
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 [...]
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. [...]
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 [...]
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 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 [...]