Physician Fee Schedules: How Do They Compare and What’s Next?
When you visit your doctor, you will typically be charged a small copay, coinsurance amount, or may not [...]
Defining a Bundled Payment Rate for Bone Marrow Transplants
Summary Insurers and providers are increasingly pushing for bundled payments and other forms of value-based reimbursement in their [...]
The Cost of Consolidation
Consolidation is aggressively moving through much of the US economy. Everything from coffee shops to airlines are consolidating [...]
Closing the Loop on Value Based Reimbursement and Incentive Programs
The phrase “closing the loop” is often used when traditional communication approaches have failed or have been ineffective. [...]
Developing Financial Projections for Start-Up Health Plans
Summary Throughout the United States, new health plans are emerging as provider systems and nontraditional organizations seek to [...]
How is Your DOFR Doing?
Purpose of DOFRs A Division of Financial Responsibility (DOFR) is a provision in a contract between a health [...]
Should You Be Concerned About Low Rate Increases?
Health care costs are too high. What health care products or services come to mind when you read [...]
Measuring ROI For A Pediatric Care Intervention Program
Summary Determining an ROI for any care program or intervention can be challenging, but the challenge was multiplied [...]
An Actuarial View of Health Care Public Policy Proposals
The number of bills which purport to expand access to public health insurance plans is now in [...]
An Actuary Looks at 50
It’s been twenty-five years since I began my daily routine of putting on a [...]