Healthcare Risk Adjustment and Predictive Modeling - read free eBook in online reader or directly download on the web page. Select files or add your book in reader. Download and read online ebook Healthcare Risk Adjustment and Predictive Modeling write by Ian G. Duncan. This book was released on 2011. Healthcare Risk Adjustment and Predictive Modeling available in PDF, EPUB and Kindle. This text is listed on the Course of Reading for SOA Fellowship study in the Group & Health specialty track. Healthcare Risk Adjustment and Predictive Modeling provides a comprehensive guide to healthcare actuaries and other professionals interested in healthcare data analytics, risk adjustment and predictive modeling. The book first introduces the topic with discussions of health risk, available data, clinical identification algorithms for diagnostic grouping and the use of grouper models. The second part of the book presents the concept of data mining and some of the common approaches used by modelers. The third and final section covers a number of predictive modeling and risk adjustment case-studies, with examples from Medicaid, Medicare, disability, depression diagnosis and provider reimbursement, as well as the use of predictive modeling and risk adjustment outside the U.S. For readers who wish to experiment with their own models, the book also provides access to a test dataset.
Predictive Modeling
Predictive Modeling - read free eBook in online reader or directly download on the web page. Select files or add your book in reader. Download and read online ebook Predictive Modeling write by Dr. Howard Brill. This book was released on 2005-12-01. Predictive Modeling available in PDF, EPUB and Kindle. Eighth in the Disease Management Dimensions Series-Save 35 percent when you order the Disease Management Dimensions Series. Keenly aware of the increased presence of toolkits in the healthcare industry, the Healthcare Intelligence Network (HIN) sponsored a Healthcare Toolkits contest in summer 2005. This special report, Blueprint for Success: Constructing a Winning Healthcare Toolkit Strategy takes an in-depth look at the first-, second- and third-place winners and the creative teams and processes behind them, from development to production to distribution. Melanie Matthews, HIN's executive vice president and chief operating officer, invited the toolkit strategists to share their experiences on launching a toolkit in a recent roundtable discussion. This 35-page report also details the results of an October 2005 online survey on the use of toolkits in the healthcare industry. You'll hear from the award-winning toolkit development teams at The Eden Communications Group, PacifiCare Behavioral Health and Blue Cross Blue Shield of Michigan as they review their blue-ribbon toolkits. Erin Lenox, associate, Hilb Rogal & Hobbs, and John Mills, director, product development, HIP Health Plans, also share their views on the mounting importance of of healthcare toolkits. You'll get details on: -Identifying a need for a toolkit; -Selecting a medium for your message; -Measuring for cultural sensitivity; -Analyzing a toolkit's effectiveness; and -Solving the "buy or build" dilemma. Table of Contents 2005 Healthcare Toolkits Contest: HINs Winners Circle Survivors Artwork Inspires Journey to Recovery for Breast Cancer Patients Ensuring Continuity of Care after an Inpatient Stay Teaching Providers to Recognize Signs of Domestic Violence The Story Behind the Toolkit Contest Traditional Toolkit Components Identifying the Need for a Toolkit Why the Winners Developed a Toolkit Research Findings Prompt Domestic Violence Toolkit Selecting a Medium for Their Message Winners Experienced Players in Toolkit Arena Factors That Impact a Toolkit Timeline Structuring the Review Process Coping with the Unexpected Getting a Good Read on Health Literacy Measuring for Cultural Sensitivity Accepted Methods of Measuring Toolkit ROI Analyzing a Toolkits Effectiveness Analysis Focuses More on Clinical Gains Than Cost Benefits Driving Adoption of Consumer Healthcare Toolkits Works in Progress: Planned Toolkit Enhancements Words of Wisdom The Winners' Take on Toolkit Trends Motivating the Healthy to Use Healthcare Toolkits The Buy or Build Dilemma Timely Topics for Healthcare Toolkits HIN Online Survey Finds Toolkits Fill Knowledge Gap,Inform Consumers Print Still Top Toolkit Delivery Format Development, Results Analysis Greatest Hurdles Always Room to Refine Collecting Feedback on Toolkits Toolkit Developers Share Recipient Feedback Plans Underway for 2006 Healthcare Toolkits Contest "Blueprint for Success: Constructing a Winning Healthcare Toolkit Strategy" is part of HIN's Disease Management Dimensions series. Disease Management Dimensions provides an inside look at disease management programs to help you get the most of your disease management initiatives.
Managing and Evaluating Healthcare Intervention Programs
Managing and Evaluating Healthcare Intervention Programs - read free eBook in online reader or directly download on the web page. Select files or add your book in reader. Download and read online ebook Managing and Evaluating Healthcare Intervention Programs write by Ian Duncan, FSA, FIA, FCIA, MAAA. This book was released on 2014-01-20. Managing and Evaluating Healthcare Intervention Programs available in PDF, EPUB and Kindle. Since its publication in 2008, Managing and Evaluating Healthcare Intervention Programs has become the premier textbook for actuaries and other healthcare professionals interested in the financial performance of healthcare interventions. The second edition updates the prior text with discussion of new programs and outcomes such as ACOs, Bundled Payments and Medication Management, together with new chapters that include Opportunity Analysis, Clinical Foundations, Measurement of Clinical Quality, and use of Propensity Matching.
Testing Alternative Regression Frameworks for Predictive Modeling of Healthcare Costs
Testing Alternative Regression Frameworks for Predictive Modeling of Healthcare Costs - read free eBook in online reader or directly download on the web page. Select files or add your book in reader. Download and read online ebook Testing Alternative Regression Frameworks for Predictive Modeling of Healthcare Costs write by Ian Duncan. This book was released on 2015. Testing Alternative Regression Frameworks for Predictive Modeling of Healthcare Costs available in PDF, EPUB and Kindle. Predictive models of healthcare costs have become mainstream in much healthcare actuarial work. The Affordable Care Act requires the use of predictive modeling-based risk-adjuster models to transfer revenue between different health exchange participants. While the predictive accuracy of these models has been investigated in a number of studies, the accuracy and use of models for applications other than risk adjustment has not been the subject of much investigation. We investigate predictive modeling of future healthcare costs using a number of different statistical techniques. Our analysis was performed based on a dataset of 30,000 insureds containing claims information from two contiguous years. The dataset contains over a hundred covariates for each insured, including detailed breakdown of past costs and causes encoded via coexisting condition (CC) flags. We discuss statistical models for the relationship between next-year costs and medical and cost information to predict the mean and quantiles of future cost, ranking risks and identifying most predictive covariates. A comparison of multiple models is presented, including (in addition to the traditional linear regression model underlying risk adjusters) Lasso GLM, multivariate adaptive regression splines, random forests, decision trees, and boosted trees. A detailed performance analysis shows that the traditional regression approach does not perform well and that more accurate models are possible.
The Future of Disability in America
The Future of Disability in America - read free eBook in online reader or directly download on the web page. Select files or add your book in reader. Download and read online ebook The Future of Disability in America write by Institute of Medicine. This book was released on 2007-10-24. The Future of Disability in America available in PDF, EPUB and Kindle. The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society.
