Pandemic Reserves
As I sit at my desk looking out the window at the rain covered streets, barely a person in sight and cars randomly scattered on the curb, it is hard not to think, “should we have seen this...
Economics and Healthcare
When making important business decisions it is critical to evaluate them in economic terms, oftentimes boiled down to supply and demand. According to www.investopia.com[1], demand...
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...
Transparency: How Important Is It Anyway?
The November 15, 2019 release of a final rule on Transparency has raised the awareness of transparency. For years this has been a discussion topic in Board Rooms, marketing departments...
What Is The “Total Cost Of Care” And Why Does It Matter?
If you work in the healthcare space, you often hear the term “Total Cost of Care”. The more you hear the term the more you may wonder what it means and why it is important...
Transforms: a la Health Care Style
Students of mathematics are familiar with the concepts of transforms or transformations (e.g., LaPlace or Fourier transforms). Essentially these are tools which help mathematicians...
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 even have to make a payment at all. This is done because you know that your...
Streamline Your Healthcare Analytics by Embedding Benchmarking
Too often meaningless and unnecessarily complex healthcare analysis is prepared and presented to leadership without explaining what it means or answering the key question “what do I do with this?”...
RBC in an ACA World: Determining an Optimal Surplus Range
The Patient Protection and Affordable Care Act (ACA) brought new risks and volatility to the world of health insurance. The prospect of insuring a previously uninsured population...
What You Need to Know About Shared Savings Financial Targets
What You Need to Know About Shared Savings Financial Targets A Brief History of Risk-Based Contracting Risk [...]