Financial analysis of ACA health plan issuers, By Daniel J. Perlman and David M. Liner
A summary of 2014 risk mitigation estimates with actual amounts published by the Center for Consumer Information and Insurance Oversight.
Are you ready for the new world of value-based reimbursement?, By Marla Pantano
The emergence of alternative payment models requires healthcare providers to develop expertise in areas where many of them currently have little expertise.
Provider Analytic Needs
Encounter data standards: Implications for state Medicaid agencies and managed care entities from final Medicaid managed care rule, By Jeremy Cunningham, Maureen Tressel Lewis, and Paul R. Houchens
Relative to other sources of data that may be used in developing capitation rates—summarized managed care entity (MCE) utilization and cost experience, fee-for-service data, statutory financial statements, etc.—encounter data provides the most transparent view of an MCE’s provision of healthcare services.
The elusive nature of private exchanges, By Mike Gaal
To understand why private exchange enrollment is so far below the initial forecasts, we need to consider the driver of the optimistic growth.
Money market update for 2016: The rule that you should be aware of, By Jeffrey T. Marzinsky
The amendment to the Investment Advisors Act of 1940, which took effect in October, focuses on the ability of money markets to maintain adequate liquidity and manage redemptions, especially in times of market stress.
DFS Moneyball: Beating daily fantasy sports with predictive analytics, By Michael A. Henk and Nicholas Blaubach
Daily fantasy sports contests continue to sweep the globe despite well documented and yet to be resolved concerns regarding legality.
Provider payment: What does risk adjustment have to do with it, By Ksenia Whittal
The tide of change is drifting toward improvement in the quality of care and risk sharing between providers and payers.
Student loan debt update: A look at a possible future, By Katherine A. Pipkorn and Michael A. Henk
Student loan debt is a key concern underlying the country’s economic stability.
Pokémon Go and augmented reality: Not all fun and games, By Michael A. Henk
Pokémon Go may generate extreme levels of distractedness while posing a new front for cyber risk.
Institution for Mental Disease (IMD) as an "in lieu of" service, By Mat DeLillo
Institutions for Mental Disease will continue to be a topic of interest to state policy makers as they bolster the continuum of behavioral health and substance use disorder services.
Next Generation ACO Model: Should we take the plunge?, By Charlie Mills, Cory Gusland, and Noah Champagne
Five key considerations that all accountable care organizations (ACOs) should closely review before deciding whether or not to use the Next Generation ACO Model.
Pass-through payment guidance in final Medicaid managed care regulations: Transitioning to value-based payments, By Andrew Gaffner, Carmen Laudenschlager, and Christine M. Mytelka
An overview of pass-through payment provisions in the new Medicaid managed care regulations, including the rationale and phase-out timing of the Centers for Medicare and Medicaid Services.
Pension Funding Study, By Alan H. Perry, Charles J. Clark, John W. Ehrhardt, and Zorast Wadia
In a tumultuous year that buffeted pension plans with volatile markets and interest rate movement, the 100 largest corporate defined benefit pension plans made little progress in 2015.
Milliman Medical Index, By Christopher S. Girod, Scott A. Weltz, and Susan K. Hart
In 2016, the cost of healthcare for a typical American family of four covered by an average employer-sponsored preferred provider organization plan is $25,826, according to the Milliman Medical Index.
Pension Funding Index, By John W. Ehrhardt and Zorast Wadia
Monthly reports on the funded status of the 100 largest corporate defined benefit pension plans as measured by the Milliman 100 Pension Funding Index.