Healthcare Risk Adjustment and Predictive Modeling

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ACTEX Publications, 2011 - Health risk assessment - 338 pages

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.

 

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Great read.very helpfull

User Review - Flag as inappropriate

This 'appetizer' portion of Mr. Duncan's book is quite good and in fact prompted me to buy a hard copy
for use. I anticipate using it weekly if not daily and look forward to the book's arrival.

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