Population Risk Management: Reducing Costs and Managing Risk in Health Insurance

Ian Duncan and Arthur Robb
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Ian Duncan: Lotter Actuarial Partners, 915 Broadway Suite 607, New York, NY 10010, USA
Arthur Robb: Landacorp Inc., 4151 Ashford Dunwoody Road Suite 505, Atlanta, GA 30319, USA

Chapter 7 in Intelligent and Other Computational Techniques in Insurance:Theory and Applications, 2003, pp 261-298 from World Scientific Publishing Co. Pte. Ltd.

Abstract: AbstractThe following sections are included:BackgroundWhat Is a High-Risk Member?Elements of Population Risk ManagementIdentification (Targeting) of High-Risk PopulationsData: Available SourcesMedical ChartsSurvey DataMedical ClaimsPharmacy ClaimsLaboratory ValuesConclusions on DataImplementation Issues and How They Affect Prediction MethodologiesGoalsBudgetsStaffingComputing ResourcesData WarehousingPrediction MethodologiesClinical MethodsStatistical MethodsApplication of Interventions and Other Risk Management TechniquesTargeting the Right MembersEffectiveness and OutcomesResults, Including a Methodology for Optimizing Inputs to and Estimating Return on Investment from Intervention ProgramsUsing the Risk Management Economic ModelSummary and ConclusionsReferences

Keywords: Insurance; Actuarial Science; Neural Networks; Fuzzy Systems; Computational Intelligence; Computational Techniques; Life and Health Insurance; Property and Casualty Insurance (search for similar items in EconPapers)
Date: 2003
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