Actuarial Outpost
 
Go Back   Actuarial Outpost > Actuarial Discussion Forum > Health - Disability
FlashChat Actuarial Discussion Preliminary Exams CAS/SOA Exams Cyberchat Around the World Suggestions


Reply
 
Thread Tools Search this Thread Display Modes
  #2271  
Old 11-09-2016, 09:34 AM
campbell's Avatar
campbell campbell is offline
Mary Pat Campbell
SOA AAA
 
Join Date: Nov 2003
Location: NY
Studying for duolingo and coursera
Favorite beer: Murphy's Irish Stout
Posts: 83,236
Blog Entries: 6
Default

Quote:
Originally Posted by Mr F View Post
There isn't really much interesting about it. It was horribly written and deserved to fail. Leaders on both sides were heavily against it.
Fair enough. It was just that it was so lopsided compared to all the other props.
__________________
It's STUMP

LinkedIn Profile
Reply With Quote
  #2272  
Old 11-09-2016, 10:02 AM
Mr F's Avatar
Mr F Mr F is offline
Member
SOA
 
Join Date: Jun 2009
Posts: 4,789
Default

Quote:
Originally Posted by campbell View Post
Fair enough. It was just that it was so lopsided compared to all the other props.
It was that horribly written. It was bad enough that it was a major contributing factor on getting another vote on an amendment that would make it harder to get an amendment like ColoradoCare on the ballot in the first place, and that vote won.
Reply With Quote
  #2273  
Old 11-10-2016, 11:56 AM
George Frankly's Avatar
George Frankly George Frankly is offline
Member
SOA AAA
 
Join Date: Aug 2011
Location: CO
Favorite beer: Sam Smith Oatmeal
Posts: 9,733
Default

Quote:
Originally Posted by Mr F View Post
It was that horribly written.
It really was. I think if we got three AOers together for a long weekend, we could author something significantly better, and I'm assuming that we do quite a bit of drinking during the event.
Reply With Quote
  #2274  
Old 11-10-2016, 02:13 PM
Dr T Non-Fan Dr T Non-Fan is offline
Member
SOA AAA
 
Join Date: Sep 2001
Location: Just outside of Nowhere
Posts: 91,923
Default

Quote:
Originally Posted by George Frankly View Post
It really was. I think if we got three AOers together for a long weekend, we could author something significantly better, and I'm assuming that we do quite a bit of drinking during the event.
And smoking, if in Colorado. 'cause, working on something like that would make your brain hurt a bit, and would require medication.
__________________
DTNF's Basic Philosophy Regarding Posting: There's no emoticon for what I'm feeling! -- Jeff Albertson (CBG)
DTNF's Trademarked Standard Career Advice: "pass some exams and get back to us."
DTNF's Major advice: "Doesn't matter. Choose major that helps you with goal of Career Advice."
DTNF's Résumé Advice: Have a good and interesting answer to every item on it for the interviews.
DTNF's Law of Job Offers: You not only have to qualify for the position, but you also have to be the best candidate available for the offer.
DTNF's Work Philosophy: I am actuary. Please insert data. -- Actuary Actuarying Rodriguez.
Twitches' Advice to Crazy Women: Please just go buy your 30 cats already.
Reply With Quote
  #2275  
Old 11-10-2016, 11:41 PM
Captain Oveur Captain Oveur is offline
Member
SOA
 
Join Date: Jul 2013
Posts: 12,704
Default

Quote:
Originally Posted by Ron Swanson View Post
There is a whole industry dedicated to risk score increasing activities, many of which depend on knowing who has chronic conditions so you can work to get a claim for them. (chart reviews, efforts to get the member to see a provider and generate a claim, etc.) Past data helps you know who to go after.
whom*
Reply With Quote
  #2276  
Old 08-09-2017, 12:04 PM
campbell's Avatar
campbell campbell is offline
Mary Pat Campbell
SOA AAA
 
Join Date: Nov 2003
Location: NY
Studying for duolingo and coursera
Favorite beer: Murphy's Irish Stout
Posts: 83,236
Blog Entries: 6
Default

NEVADA

http://www.thinkadvisor.com/2017/08/...paign=08092017

Quote:
Nevada Exchange to HealthCare.gov: Please Talk to Us

Managers of the Affordable Care Act public health insurance program in Nevada are facing the same kind of confusion about the 2018 market that's plaguing ordinary insurance agents and brokers.

Heather Korbulic, the executive director of Nevada's Silver State Health Insurance program, talks about the confusion in a monthly update she prepared for an upcoming program board meeting.

Korbulic says she and colleagues at other state-based ACA exchange programs have been asking the Centers for Medicare and Medicaid Services questions about how the 2018 individual major medical open enrollment period might work.

"I have yet to receive any answers to my questions, or indication as to when we will receive answers," Korbulic writes in the update.


.....
2018 Open Enrollment Period

The ACA public exchange system came to life in 2014. For the past few years, the open enrollment period has run from Nov. 1 through Jan. 31 in most of the country.

This year, HealthCare.gov managers plan to shorten the open enrollment period for 2018. The open enrollment period is now set to run from Nov. 1 through Dec. 15.

Korbulic writes in the update that she and her colleagues want to know what kind of infrastructure HealthCare.gov managers have to support the shortened open enrollment period.

State exchange program managers also want to know how HealthCare.gov will reach out to consumers.

The lack of answers "is particularly frustrating, considering the [Nevada] exchange is set to spend over $5 million to lease HealthCare.gov for 2017," Korbulic writes.

Nevada will offer its own state-funded marketing program regardless of what HealthCare.gov, Korbulic says.
the notes:

https://d1q4hslcl8rmbx.cloudfront.ne...1017_Final.pdf

Quote:
Over the past five months the Exchange has been keenly focused on strategy for open enrollment
period five (OE5). The challenges for OE5 are daunting – a truncated enrollment period (90 days
down to 45 days), unknown support from HealthCare.gov, and the longstanding limitations of
having no member-level data. My colleagues from other State Based Marketplaces utilizing the
Federal Platform (SBM-FP) and I have collectively and individually requested information from
the Centers from Medicare and Medicaid (CMS) regarding the ability of HealthCare.gov’s
infrastructure to support a truncated open enrollment period, details about what kind outreach
they will be making to our consumers, and specific information about HealthCare.gov’s plans for
outreach and marketing for the upcoming open enrollment period. I have yet to receive any
answers to my questions, or indication as to when we will receive answers; which is particularly
frustrating considering the Exchange is set to spend over five million dollars to lease
HealthCare.gov for 2017. I will remain committed in my requests; meanwhile the Exchange will
continue to develop targeted outreach and actively engage consumers through Nevada Health
Link’s advertising campaign regardless of the answers we may or may not receive.
__________________
It's STUMP

LinkedIn Profile
Reply With Quote
  #2277  
Old 08-11-2017, 12:38 PM
Sredni Vashtar's Avatar
Sredni Vashtar Sredni Vashtar is offline
Member
 
Join Date: Mar 2010
Favorite beer: pilseners
Posts: 6,291
Blog Entries: 1
Default

Quote:
Originally Posted by BernieSanders2016 View Post
The critics’ chief complaint is that the Affordable Care Act’s risk-adjustment program unfairly rewards health plans — including Blue Shield of California — that have excess administrative costs and higher premiums.
Quote:
Nowhere in the risk transfer formula does it include administrative costs. The only place it uses actual premium charged is the state market average premium which the total transfer amount is scaled by. Because the markets have been underpriced on average in the last 3 years, it has actually dampened the effect of risk adjustment. If the markets had been appropriately priced, the plans with sicker members would have received a larger transfer.
I think you're misunderstanding the argument. The point is that RA is supposed to balance out claims. In the formula, premium is being used as a proxy for claims. But since premium is larger than claims, it makes for an inappropriate scale. You need to scale it down some. If you want to balance out claims, then instead of scaling by premium, you want to scale by (premium-admin)

I think you might correctly argue back that higher claims results in higher admin. And that the true number should be based on variable costs, or something. I dunno.
__________________
Sredni Vashtar went forth,
His thoughts were red thoughts and his teeth were white.
His enemies called for peace, but he brought them death.
Sredni Vashtar the Beautiful.

Last edited by Sredni Vashtar; 08-11-2017 at 12:42 PM..
Reply With Quote
Reply

Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off


All times are GMT -4. The time now is 05:50 PM.


Powered by vBulletin®
Copyright ©2000 - 2018, Jelsoft Enterprises Ltd.
*PLEASE NOTE: Posts are not checked for accuracy, and do not
represent the views of the Actuarial Outpost or its sponsors.
Page generated in 0.34170 seconds with 12 queries