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Search: Posts Made By: WhosOnFirst
Forum: Health - Disability 01-02-2020, 04:36 PM
Replies: 45
Views: 5,028
Posted By WhosOnFirst
Good questions. There wouldn't be a legal...

Good questions.

There wouldn't be a legal issue with a model that has bias against a non-protected class. However, there could be other damage done to a company's reputation. For example, if a...
Forum: Non-Actuarial Personal Finance/Investing 11-05-2019, 02:08 PM
Replies: 34
Views: 2,881
Posted By WhosOnFirst
Or they don't plan on staying insured on this...

Or they don't plan on staying insured on this plan for the full year. For example, employee plans on having surgery in January. Out for six weeks on disability. Retires in February.

This might...
Forum: Health - Disability 11-04-2019, 02:10 PM
Replies: 70
Views: 15,876
Posted By WhosOnFirst
Great ideas. We should try those at some point. ...

Great ideas. We should try those at some point.

I just took a quick look at the Haven website. Their leadership team doesn't have a chief actuary listed. I'm thinking this is a great...
Forum: Health - Disability 11-04-2019, 01:57 PM
Replies: 70
Views: 15,876
Posted By WhosOnFirst
I'm assuming that you don't mean the text book...

I'm assuming that you don't mean the text book difference between the two.

I think the idea is that there is a flat known cost going into a procedure or for a drug. If you are focused on the...
Forum: Health - Disability 11-04-2019, 01:39 PM
Replies: 14
Views: 1,427
Posted By WhosOnFirst
I haven't worked with an ACA product in awhile. ...

I haven't worked with an ACA product in awhile. What is different with the subsidies this year versus last year?
Forum: Health - Disability 11-04-2019, 01:38 PM
Replies: 45
Views: 5,028
Posted By WhosOnFirst
Per the article, "At a given risk score, Black...

Per the article, "At a given risk score, Black patients are considerably sicker than White patients, as evidenced by signs of uncontrolled illnesses. Remedying this disparity would increase the...
Forum: Health - Disability 11-01-2019, 11:59 AM
Replies: 45
Views: 5,028
Posted By WhosOnFirst
Optum didn't sell a model that predicted claim...

Optum didn't sell a model that predicted claim cost for patients. They sold a model to hospitals to triage patients that needed the most care first. It should be obvious why a model intended to...
Forum: Health - Disability 10-31-2019, 12:21 PM
Replies: 45
Views: 5,028
Posted By WhosOnFirst
All models have some level of bias because they...

All models have some level of bias because they do not incorporate perfect data. Sometimes that bias is not relevant. For example, Amazon's model that suggests other items of interest that you...
Forum: Health - Disability 10-30-2019, 11:51 AM
Replies: 45
Views: 5,028
Posted By WhosOnFirst
:iatp: I don't think this can be emphasized...

:iatp:

I don't think this can be emphasized enough. If something is found to be discriminatory it doesn't matter if the cause was unintentional. United is in a world of hurt here I think because...
Forum: Health - Disability 10-29-2019, 11:26 AM
Replies: 45
Views: 5,028
Posted By WhosOnFirst
One clarification on the insurance angle. I...

One clarification on the insurance angle. I believe this is an algorithm used by hospitals to triage patients. While Optum is owned by United Healthcare, this algorithm is used by hospitals. They...
Forum: Health - Disability 10-28-2019, 11:28 AM
Replies: 45
Views: 5,028
Posted By WhosOnFirst
Thanks for the article. This has been a personal...

Thanks for the article. This has been a personal concern of mine for awhile now. Bias should be expected in any sort of AI model that you develop. That bias may be okay when it comes to a...
Forum: Health - Disability 08-22-2019, 09:56 AM
Replies: 9
Views: 2,660
Posted By WhosOnFirst
I second selectstar, DoctorNo is the one you want...

I second selectstar, DoctorNo is the one you want to talk to. However, if you want some more pedestrian advice I'll add two cents worth. You can estimate the transfer amount by using the actual...
Forum: Health - Disability 08-13-2019, 11:42 AM
Replies: 96
Views: 25,864
Posted By WhosOnFirst
Behavior modification does work to help some...

Behavior modification does work to help some people overcome addiction, I wouldn't deny that. The reason Alcoholics Anonymous has been around for so long is that it does help some people. However,...
Forum: Health - Disability 08-09-2019, 10:17 AM
Replies: 16
Views: 2,286
Posted By WhosOnFirst
What kind of insurance product has a group of...

What kind of insurance product has a group of 100,000 or more members? I can't even fathom a 1,000,000 person group.

And if the group is that big, why are they complaining about specific rating...
Forum: Health - Disability 08-09-2019, 10:06 AM
Replies: 23
Views: 3,343
Posted By WhosOnFirst
Doh! That's what happens when I don't go back...

Doh! That's what happens when I don't go back and re-read a thread.

I take back everything I implied about Mark Farrah Associates. I've not worked with them before and therefore have no opinion...
Forum: Health - Disability 08-09-2019, 09:44 AM
Replies: 11
Views: 1,788
Posted By WhosOnFirst
Fortunately, I don't need to play nice. By the...

Fortunately, I don't need to play nice. By the time I get called in now, the consultants know I'm going to be replicating whatever it was they did or modeling their process with our data. It is my...
Forum: Health - Disability 08-08-2019, 01:01 PM
Replies: 11
Views: 1,788
Posted By WhosOnFirst
I was once told in a training class that I needed...

I was once told in a training class that I needed to stop asking questions about the tool we were being shown. I am also generally not invited to meet with any consultants we hire anymore.

I find...
Forum: Health - Disability 08-07-2019, 01:01 PM
Replies: 11
Views: 1,788
Posted By WhosOnFirst
I read the report. I draw some very different...

I read the report. I draw some very different conclusions in some parts and I disagree with the conclusion that the wellness program generated the differences that are shown. There is bias in the...
Forum: Health - Disability 08-07-2019, 10:30 AM
Replies: 11
Views: 1,788
Posted By WhosOnFirst
Humana Wellness Program

https://www.bizjournals.com/louisville/news/2019/08/07/humanas-employee-wellness-plan-showed-real-results.html?ana=yahoo&yptr=yahoo

There is a link to the report on the study. I have a ton of...
Forum: Health - Disability 08-06-2019, 01:45 PM
Replies: 23
Views: 3,343
Posted By WhosOnFirst
Ah, pretty certain I know exactly who put that...

Ah, pretty certain I know exactly who put that study together. Or at least narrowed down to two. I don't trust them either although our management uses them sometimes. Too much black box hand...
Forum: Health - Disability 08-06-2019, 10:11 AM
Replies: 23
Views: 3,343
Posted By WhosOnFirst
I suspected that kind of answer. ;-) I'm...

I suspected that kind of answer. ;-) I'm guessing that Census numbers are at the heart of the analysis. Take those with a very large grain of salt. Boulder size grains in my opinion. I was...
Forum: Health - Disability 07-29-2019, 12:41 PM
Replies: 23
Views: 3,343
Posted By WhosOnFirst
As noted by others, I'm not certain this study...

As noted by others, I'm not certain this study provides much information. Without knowing the impact of ASO and the growth of Medicare it isn't possible to draw conclusions on trends in these other...
Forum: Health - Disability 07-29-2019, 12:14 PM
Replies: 51
Views: 10,221
Posted By WhosOnFirst
The example I provided was simplified and used...

The example I provided was simplified and used lower than actual expected numbers to drive the costing point home. The doc who originally posted about maternity benefits doesn't have any pricing...
Forum: Health - Disability 07-16-2019, 10:41 AM
Replies: 51
Views: 10,221
Posted By WhosOnFirst
If the Bind plans are offered in along with high...

If the Bind plans are offered in along with high deductible plans, pricing might prove even trickier than I had originally thought. But no, I was thinking the Bind plan was offered in isolation. ...
Forum: Health - Disability 07-15-2019, 10:12 AM
Replies: 51
Views: 10,221
Posted By WhosOnFirst
That is all true. But the steerage mechanism...

That is all true. But the steerage mechanism they use is based upon a single cost to the employee depending on the doctor and facility they use along with the treatment path they have taken. it...
Showing results 1 to 25 of 129

 

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