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 [...]
Benchmarking Without Benchmarks
Introduction Benchmarks are very useful and a great tool for deciphering analytics. They offer a point of [...]
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 [...]
Resource Based Pricing
Introduction Some of the confusion about the US health care system is directly tied to prices. How [...]
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 [...]
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 [...]
Defining a Winning Health Care Growth Strategy
One of the most challenging tasks in today's highly competitive marketplace is defining a winning strategy. This is [...]
Defining the Modern Actuary
Introduction When many people think of an actuary their mind immediately goes to a very nerdy introverted [...]
The Value of Data Lakes in Healthcare IT
As the number of healthcare data sources continues to grow, and the variety of data formats and delivery [...]
Thoughts on the Aetna and United Deals
I have been reading the recent articles about CVS purchasing Aetna and United's purchase of Davita's physician [...]