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Grp&HlthAdv_MF

This class was created by Brainscape user Claudia Forest. Visit their profile to learn more about the creator.

By: Claudia Forest
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Decks in this class (18)

Sec I Provider Payments
Principles for designing provider...,
Users of provider profiles,
Contracting considerations for di...
25  cards
Sec K EHM Programs
Recommended measures for assessin...,
Steps of the ehm value chain,
Ehm value proposition
11  cards
Sec G Care Management
Components of the care management...,
Risk factors for care management ...,
Components for designing a care m...
16  cards
Sec D PDRs & Oth Reserves
Principles for determining premiu...,
Assumptions needed to estimate pr...,
Contract groupings for premium de...
17  cards
Sec H DM Programs
Key metrics in the design of dise...,
Issues that affect disease manage...,
Issues related to determining and...
15  cards
Sec J ACA
Small group insurance underwritin...,
Large group program design consid...,
Impact of the aca exchanges on la...
11  cards
Sec F ACOs
Definition of accountable care or...,
Key success factors of an account...,
Providers eligible to participate...
13  cards
Sec N ASOPs
Statement the actuary must make i...,
Asop considerations for estimatin...,
Types of statements of actuarial ...
17  cards
Sec L Anti-selection
Approaches used for modeling anti...,
Situations in which the cast mode...,
Requirements that mitigate antise...
7  cards
Sec A Drugs
Services provided by medication t...,
Formulary guidelines for part d p...,
Definition and types of drug form...
10  cards
Sec C Claims Reserves & Liabs
Methods for estimation for claim ...,
Methods for evaluating claim rese...,
Process of building in conservati...
9  cards
Sec M Grp LTD/LTC
Uses of credibility for group lon...,
Challenges in applying credibilit...,
Reasons ltd claim experience tend...
9  cards
Sec P MH, PCMHs, Pmt Reform
Types of services delivered by co...,
Types of mental health providers,
Utilization management strategies...
20  cards
Sec B Stop Loss, Self Fund, Underwriting
Basic forms of stop loss coverage,
Stop loss contract types,
Steps for setting aggregate stop ...
17  cards
Sec Q Key Outcome Measure, Triple Aim, Reporting
Key measurement principles that a...,
Menu of triple aim outcome measur...,
Domains of quality from the agenc...
10  cards
Sec R Risk Adj Model, Disability Term Rates
Definition steps and uses of heal...,
Components of the risk management...,
Considerations in assessing trend...
9  cards
Sec S Exp Rate, Multi-Choice, LGs, SGs, Refund Form, Cred Lvls
Steps for developing premium rate...,
Situations where employees may be...,
Factors that influence an employe...
17  cards
Sec T Prop Score, Lvl Fund, Cred Form, & Canada
Description of propensity score m...,
Steps for applying propensity sco...,
Comparison of propensity scoring ...
14  cards

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Grp&HlthAdv_MF

  • Class purpose General learning

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