Thoughts on Kaiser Acquiring Geisinger
A former colleague came across an article I wrote last year, 'My Recent Experience with Kaiser Health System' – Axene Health Partners, LLC. After reading the article, she reached out to ask my thoughts...
Health Actuary vs Data Scientist: What is the difference?
Our firm recently hired its first data scientist to complement the consulting team of health actuaries and clinicians. The Actuarial profession is very small and niche, with many people outside of the insurance and pension industries...
History of Competition Between “Blues” Health Plans and a Recent Antitrust Settlement
Many people think Blue Cross and Blue Shield is the name of a health insurance company. When asked, we often hear people say, “My health insurance is through Blue Cross”. They get confused when followed-up with...
Health Care Provider Pinch: COVID-19’s Impact on Provider Revenues
The U.S. healthcare system pre-dominantly operates using a Fee-For-Service (FFS) reimbursement model. This means doctors, hospitals, and other healthcare providers are reimbursed per healthcare...
Healthcare Contingency Reserves: Expanding Beyond Financial Resources to include Physical Resources
In the U.S. insurance industry, health insurers are known to hold onto large amounts of cash reserve as a surplus. Regulators often scrutinize these reserves, demanding to know why the...
Catastrophic Claim Volatility and Stop-Loss Considerations for Self-Funded Plans
In response to a prior article I recently authored, Risk-Based Capital Considerations for Self-Funded Plans, I had a request for a follow-up article focused on stop-loss as a risk mitigation...