When is the Right Time to Move to Risk Sharing?
With all of the discussion today about Alternate Payment Methods, Value Based Reimbursement, MACRA, MIPS, etc., talk very quickly [...]
Do Employees Really Understand Their Coverage?
One of the most talked about things in the United States is healthcare, but it is surprising to find [...]
Is Self-Funding the Right Choice?
Does going Self-Funded really save your money, or does it just sound good… No matter how big or small [...]
Is it Time for an ACO Check-up?
With school soon to start many parents are scheduling check-ups for their kids to be sure all is well. [...]
So How Much Profit is Enough? Guidance for Pricing Health Benefits
One of the key assumptions in health product premium rate development is the profit margin (i.e., contribution to surplus, [...]
Benchmarking Without Benchmarks
Introduction Benchmarks are very useful and a great tool for deciphering analytics. They offer a point of reference [...]
Perverse Incentives in ACA’s Risk Adjustment
Introduction There has been significant discussion in the past several weeks about ACA’s risk adjustors, the New Mexico court [...]
Resource Based Pricing
Introduction Some of the confusion about the US health care system is directly tied to prices. How much does [...]
Leveling the Playing Field: How Actuaries Can Help Provider Organizations Negotiate Fair and Effective Risk Contracts with Insurers
“What You Don’t Know Will Hurt You” – Jim Rohn, American entrepreneur, author and motivational speaker. Introduction As risk [...]
An AHP Round Table: The Proposed Amazon, Berkshire, J.P. Morgan Health Benefits and Delivery Alliance
Anytime Amazon enters a new marketplace they make waves. Their recent acquisition of Whole Foods shocked the grocery [...]