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


Upload your resume securely at https://www.dwsimpson.com
to be contacted when new jobs meet your skills and objectives.


Reply
 
Thread Tools Search this Thread Display Modes
  #21  
Old 05-02-2013, 04:33 PM
FormLetter's Avatar
FormLetter FormLetter is offline
Member
 
Join Date: Feb 2006
Posts: 49,283
Default

Quote:
Originally Posted by Dr T Non-Fan View Post
The Risk Adjusters will help a lot as well. In the 80's there was no risk adjustment, and there was an alternative to red tape for the less-healthy folk (thus a lot of selection bias).
Since Risk Adjusters are already being used for Med Advantage (I cannot attest to their predictability), that's one thing my (not FL's) plan has going for it.
Point: me.
I have limited experience with Medicaid, but the few states I've dealt with Medicaid used a form of risk adjusters as well. They're different models than the HCC model CMS uses for MA, but still risk adjusted.
__________________
Come join the AO Rap Battle Tournament 2013:
http://www.actuarialoutpost.com/actu...33#post7082433
Reply With Quote
  #22  
Old 05-02-2013, 04:34 PM
Practicing's Avatar
Practicing Practicing is offline
Member
SOA
 
Join Date: Sep 2010
Location: NYC
Posts: 872
Default

Quote:
Originally Posted by Notus View Post
And I'm sure absolutely no one would object to this over privacy concerns
Privacy isn't really the issue, in my opinion. They basically already do this for Medicare.
__________________
P FM MFE MLC C VEE IA FA


Quote:
Originally Posted by Abraham Weishaus View Post
I thought the actual exam was very similar to one of the last 2 ASM practice exams, but perhaps those underestimate the difficulty of the exam.
Reply With Quote
  #23  
Old 05-06-2013, 08:10 PM
Typikon Typikon is offline
 
Join Date: Oct 2009
Posts: 11
Default

What made me spit up when I read the article was that for his whole scheme to work, he has the PCP deciding when he wants to see the patient, not the other way around. (p. 27, middle collumn).

So we have a real-life example of an inductive proof from our days of High School Geometry:

Because all the assumptions lead to something as stupid as the doctor calling me for an appointment, somewhere, somehow, his assumptions are off.

Or perhaps all of them.

Also, what on earth is the role of the Health Care Exchange if there is no premium and no cost-sharing? Just differences in administrators? If the doctor is in charge of the patient, why in the heck not make the doctor in charge of picking the administrator? AFter all, we can't expect the patient to keep up with all the details of claims administration, formularies, etc. That way, the doctor would be at risk for picking the most efficient administrator.

His "Health Care Exchange" is nothing more than an enrollment platform for a giant nationwide HMO.
Reply With Quote
  #24  
Old 05-07-2013, 01:57 PM
Dr T Non-Fan Dr T Non-Fan is offline
Member
SOA AAA
 
Join Date: Sep 2001
Location: Just outside of Nowhere
Posts: 97,533
Default

Excellent points. Thank you.
__________________
"Facebook is a toilet." -- LWTwJO

"45 es un titere" -- Seal of The President of The United States of America protest art
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 09:31 AM.


Powered by vBulletin®
Copyright ©2000 - 2019, 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 0.14480 seconds with 11 queries