What Makes America Different?
Introduction The high cost of health care in the United States is well known, whether expressed at [...]
International Healthcare Systems: The US Versus the World
The United States is the only industrialized country in the world that does not have Universal Health [...]
The Cost-Sharing Reduction Paradox: Defunding Would Help ACA Markets, Not Make Them Implode
The health insurance industry and interested stakeholders waited anxiously last week for a decision from the Trump [...]
Building Actuarial Cost Models from Health Care Claims Data for Strategic Decision-Making
Introduction Health care spending across the country generates billions of claim records annually. Claim records originate as [...]
Could an All-Payer System Improve the Affordability of US Health Care?
Overview Do you ever get annoyed knowing that someone on your flight paid less than you did [...]
Calculating Accurate Metrics for the Actuarial Cost Model
Calculating metrics for an actuarial model sounds simple enough (just sum up the data!), but if proper [...]
The Forgotten and Undervalued Resource: Care Management
In many of our recent client situations we encounter a surprising lack of awareness and concern about the [...]
Saving the Exchanges? A Case for the Provider-Owned Health Plan
Introduction There is a lot of talk about the future of Obamacare. Many fear the exchanges are in [...]
The 24-Lever Model: Lowering Insurance Premiums
This issue of Inspire is the first in a series of Inspire issues devoted to the 24-lever model. Introduction [...]
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 [...]