Healthcare Risk Adjustment and Predictive Modeling
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Healthcare Risk Adjustment and Predictive Modeling
Listed on the Course of Reading for SOA fellowship study in the Group & Health specialty beginning 2010
Healthcare Risk Adjustment and Predictive Modeling provides a Âcomprehensive guide to healthcare actuaries and other Âprofessionals Âinterested in Âhealthcare data analytics, risk adjustment and Âpredictive Âmodeling. The book first Âintroduces the topic with discussions of health risk, available data, Âclinical Âidentification Âalgorithms for diagnostic Âgrouping and the use of grouper Âmodels. The Âsecond part of the book Âpresents the Âconcept of data mining and some of the Âcommon approaches used by modelers. The third and Âfinal section Âcovers a Ânumber of Âpredictive Âmodeling and risk Âadjustment Âcase-studies, with Âexamples from ÂMedicaid, Medicare, Disability, Âdepression diagnosis and Âprovider Âreimbursement, as well as the use of predictive modeling and risk Âadjustment outside the U.S. For readers who wish to experiment with their own models, the book also provides a test dataset.