Tag Archives: actuarial services

Not perfect, but practice makes progress for ACOs

Recently released results of the Medicare Shared Savings Program (MSSP) highlight the fact that Accountable Care Organizations need to be in it for the long haul. In August, the Centers for Medicare & Medicaid Services issued an update announcing that participating ACOs continue to show improvements in their ability to contain costs. Three hundred and […]
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Learn about business pros who can make risk less risky

When the Centers for Medicare and Medicaid Services (CMS) called on health plans to apply for a value-based insurance test project, it stipulated that interested organizations must include financial projections and that those projections must be “actuarially certified.” While that term wouldn’t stump health plans and traditional payers – for whom the use of actuaries […]
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Lessons learned from payers aid in shift to value-based care.

As fee-for-value payment models replace fee-for-volume models, providers are more often managing medical costs and risk. These are roles once dominated by payers. As providers find themselves needing to analyze risk, they can learn from health plans, employers and other payers — and adopt some of the same tools they use. One tactic providers can […]
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