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Webinar: Seven key challenges for Medicaid states considering alternative payment models28 February 2019 - By Rebecca L. Johnson and Anders Larson and Zach Hunt - Article

Webinar Agenda Attribution Claims volatility Risk adjustment Alignment with managed care Quality metrics Service carve-outs Variation in benefits and coordination with other payers  Download the webinar slides Related article Seven key challenges for Medic

Seven key challenges for Medicaid states considering alternative payment models29 January 2019 - By Anders Larson and Rebecca L. Johnson and Zach Hunt - Article

This article focuses on some of the challenges that Medicaid payers (including states and managed care organizations) face when trying to establish alternative payment models with providers.

Are you ready for New York State Medicaid value-based payment models?08 November 2018 - By Brett Friedman and Rebecca L. Johnson and Howard Kahn - Article

This paper provides a high-level overview of the New York State value-based payment models, discusses the opportunities and challenges for providers considering participation in them, and highlights the needs for sophisticated actuarial, financial, and legal expertise to address the inherent business, legal, and operational risks.

Health microinsurance instructional pricing tool05 October 2015 - By Aaron S. Wright and Ashlee Mouton Borcan and Daniel Henry and Josh Collins and Rebecca L. Johnson and Robert M. Damler - Article

Milliman and the International Actuarial Association have collaborated on a health microinsurance pricing tool for the microinsurance community.

The burden of hepatitis C virus disease in commercial and managed Medicaid populations24 September 2015 - By Christine Ferro and Rebecca L. Johnson - Article

This study analyzes the burden of hepatitis C virus infection for a typical adult population in the United States, emphasizing actual costs and utilization rates for commercial insurers and managed Medicaid players.

New insurance regulations on providers participating in alternative payment arrangements02 September 2015 - By Catherine M. Murphy-Barron and Howard Kahn and Rebecca L. Johnson and Robert Parke - Article

A recent growing trend has been to shift insurance (utilization) risk from payers to providers through alternate payment contracts (APCs) in an effort to align financial compensation with performance and financially penalize providers if certain financial and quality thresholds are not met.

Healthcare, provider reimbursement, and the changing financial terrain19 March 2015 - By Catherine M. Murphy-Barron and Rebecca L. Johnson - Article

Healthcare providers should start thinking about strategies for defending and gaining market share sooner rather than later.

Specialty tiers: Benefit design considerations for Medicare Part D26 June 2013 - By Bruce S. Pyenson and Gabriela Dieguez and Rebecca L. Johnson - Article

An examination of benefit design and costs for specialty-tier prescription drugs.

Specialty tiers: Benefit design considerations for commercial payors16 October 2012 - By Bruce S. Pyenson and Gabriela Dieguez and Rebecca L. Johnson - Article

Plan redesigns can help reduce the cost impact of specialty drugs without burdening patients or payors.


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