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MANAGED CARE RISK MODELING DECISION SUPPORT

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What is a Health Actuary? The following definition may provide some insight:

A health care actuary performs actuarial analysis which provides information to one or more decision makers in the health care marketplace; this information helps reduce the risk associated with making a decision; the health actuary thereby facilitates change in health care delivery and financing.

In many cases, the decisions involve proposed new financing or delivery arrangements, such as capitation arrangements, mental health or specialty carve-outs, or risk-sharing arrangements. The decision makers are often health care providers or government purchasers such as Medicaid. As a result, the spectrum of issues is generally broader than present in the traditional insurer/employer-purchaser environment. Finally, the proposed arrangements frequently represent relatively new models for which directly relevant data may not be available.

OK, but: "What is an actuary?"

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