An Operational Framework for Paying Physician Specialists a Risk-Adjusted Fixed Payment and Incorporating the Results in a Global Premium Rating Model: A Doctoral Dissertation - Softcover

Castro, Dr. Lyndon Troy

Softcover

ISBN 10: 1453820523 ISBN 13: 9781453820520

Publisher: CreateSpace Independent Publishing Platform, 2010

Synopsis

This doctoral dissertation reveals an approach to creating powerful actuarial pricing, underwriting rating, medical management profiling, and healthcare professional payments according to member risk characteristics. This study evaluated members within a large health insurer to determine whether a risk-adjusted regression approach could improve upon general actuarial approaches to modeling healthcare costs, profiling members for medical management interventions, and using the results to develop more robust and accurate premium rates. This dissertation can also serve as a powerful training and reference book for any health insurer, medical management group, physician practice, hospital, and other health care professional interested in understanding the inner workings of actuarial methods.

About this title

About the Author:

Lyndon T. Castro, Dr.P.H, Ms.HSA, FHFMA, RHU, CHFP, is an independent author and researcher of practical, relevant, and substantive healthcare issues. He is also the CEO of a technology start-up organization that is developing advanced green alternative energy solutions and publishes electronic eBooks, iPhone, and web media to the healthcare industry and general public.

About this edition

• Publisher: CreateSpace Independent Publishing Platform
• Publication date: 2010
• ISBN 10: 1453820523
• ISBN 13: 9781453820520
• Binding: Paperback
• Number of pages: 336