Managing and Evaluating Healthcare Intervention Programs

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ACTEX Publications, Jan 20, 2014 - Disease management - 422 pages

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.  
 

 

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Contents

Clinical Background
15
Care Management Programs and Interventions
45
5
105
The Use of the Value Chain in Care Management Program Planning
119
Clinical Quality and its Measurement
129
Understanding the Economics of Care Management Programs
163
The Example of Opportunity Analysis
183
Measuring Care Management Savings Outcomes
197
Chronic and NonChronic Member Trends
251
Random Fluctuations and Validity in Measuring
269
1 Criteria used to Classify Members into Chronic Categories
291
15
293
16
313
PART IV
332
Selective Review of the Literature
353
The Relationship Between Health Risk Factors
371

The Use of Propensity Scoring in Program Evaluation
211
12
227
Bibliography
393
Index
419

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About the author (2014)

Ian Duncan, FSA, FIA, FCIA, MAAA retired as president and founder of Solucia Consulting (now SCIO Health Analytics) in 2010 and is an Adjunct Associate Professor of Actuarial Statistics in the Dept. of Statistics & Applied Probability at the University of California, Santa Barbara. He has over 30 years of experience in healthcare and insurance product design, management, financing, pricing and delivery.  He is a frequent speaker about health outcomes, predictive modeling and risk adjustment.

Mr. Duncan holds a post-graduate degree in economics from Balliol College, Oxford and is a Fellow of the Society of Actuaries, the Institute of Actuaries (London) and the Canadian Institute of Actuaries. He is on the boards of directors of the Commonwealth of Massachusetts Health Insurance Connector Authority, the Society of Actuaries and the Bryan University Health Informatics Advisory Board.  

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