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Healthcare Risk Adjustment and Predictive Modeling
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.
Human Forms
A major rethinking of the European novel and its relationship to early evolutionary science The 120 years between Henry Fielding's Tom Jones (1749) and George Eliot's Middlemarch (1871) marked both the rise of the novel and the shift from the presumption of a stable, universal human nature to one that changes over time. In Human Forms, Ian Duncan reorients our understanding of the novel's formation during its cultural ascendancy, arguing that fiction produced new knowledge in a period characterized by the interplay between literary and scientific discourses—even as the two were separating into distinct domains. Duncan focuses on several crisis points: the contentious formation of a natural...
Managing and Evaluating Healthcare Intervention Programs
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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