An Operational Framework for Paying Physician Specialists a Risk-Adjusted Fixed Payment and Incorporating the Results in a Global Premium Rating Model - Prijzen

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 managemen...

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