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Medicare And The Aca: Shifting The Paradigm Of Fraud Detection, David P. Paul III, Sarah Clemente, Ronald McGrady, Rob Repass, Alberto Coustasse 2016 Marshall University

Medicare And The Aca: Shifting The Paradigm Of Fraud Detection, David P. Paul Iii, Sarah Clemente, Ronald Mcgrady, Rob Repass, Alberto Coustasse

Alberto Coustasse

Medicare fraud and abuse costs are estimated at 3%-10% of overall Medicare spending, which is expected to expand considerably until 2024 and as such the amount of fraud dollars would be expected to increase proportionally. The purpose of this research was to determine how recent reforms, especially the Patient Protection and Accountable Care Act, may affect Medicare fraud and abuse and to uncover the best strategies to combat Medicare fraud. The breadth of fraud and abuse within Medicare as well as recent reforms to fight fraud including legislative reforms, delivery system reforms, and other reforms including the formation of ...


[Review Of] Making Decisions About Liability And Insurance (Colin Camerer & Howard Kunreuther Eds.), Joseph M. Carreiro Jr. 2016 University of New Hampshire

[Review Of] Making Decisions About Liability And Insurance (Colin Camerer & Howard Kunreuther Eds.), Joseph M. Carreiro Jr.

RISK: Health, Safety & Environment

Review of: Making Decisions about Liability and Insurance (Colin Camerer & Howard Kunreuther eds., Kluwer Academic Publishers 1993). Figures, index, notes, tables. ISBN 0-7923-9393-7 [139 pp. Cloth $89.95. 101 Phillip Drive, Assinippi Park, Norwell MA 02061.1


Determinants Of Health Insurance Coverage For Farm Family Households: A Midwestern Study, Helen H. Jensen, William E. Saupe 2016 Iowa State University

Determinants Of Health Insurance Coverage For Farm Family Households: A Midwestern Study, Helen H. Jensen, William E. Saupe

Helen Jensen

Data from interviews with a random sample of farm households in eight counties in southwestern Wisconsin are used to describe the distribution of health insurance coverage among households and health related fringe benefits of off-farm employment. An analysis of health insurance coverage shows major factors associated with lack of health insurance to include lower total household income, larger household size, and being more conservative regarding risk in farming. Although not significant, the signs of coefficients estimated for formal education and lacking fringe benefits in operator off­ farm employment are consistent with expectations.


Book Review, Thomas G. Field Jr. 2016 University of New Hampshire

Book Review, Thomas G. Field Jr.

RISK: Health, Safety & Environment

Review of the following: lAIN HAY, MONEY, MEDICINE AND MALPRACTICE IN AMERICAN SOCIETY. (Praeger 1992) [244 pp.] Abbreviations, annotated list of personal communications, figures, glossary, index, full legal citations, notes, preface, references, tables. LC 91-38477, ISBN 0-674-13645-4. [Cloth $49.95. P.O. Box 5007, Westwood CT 06881-9990.]


Insurance Against Extreme Events: Pairing Short-Term Incentives With Long-Term Strategies, Howard Kunreuther 2016 University of Pennsylvania

Insurance Against Extreme Events: Pairing Short-Term Incentives With Long-Term Strategies, Howard Kunreuther

Penn Wharton Public Policy Initiative

Consumers tend to purchase too little insurance or purchase it too late. Consequently, taxpayers wind up bearing substantial burdens for paying reconstruction costs from extreme events. The 2005 and 2012 hurricane seasons alone cost taxpayers nearly $150 billion. There is much that can be done to better facilitate the role that insurance can play in addressing losses from extreme events, both natural and man-made.


Medicare And The Aca: Shifting The Paradigm Of Fraud Detection, David P. Paul III, Sarah Clemente, Ronald McGrady, Rob Repass, Alberto Coustasse 2016 Marshall University

Medicare And The Aca: Shifting The Paradigm Of Fraud Detection, David P. Paul Iii, Sarah Clemente, Ronald Mcgrady, Rob Repass, Alberto Coustasse

Management Faculty Research

Medicare fraud and abuse costs are estimated at 3%-10% of overall Medicare spending, which is expected to expand considerably until 2024 and as such the amount of fraud dollars would be expected to increase proportionally. The purpose of this research was to determine how recent reforms, especially the Patient Protection and Accountable Care Act, may affect Medicare fraud and abuse and to uncover the best strategies to combat Medicare fraud. The breadth of fraud and abuse within Medicare as well as recent reforms to fight fraud including legislative reforms, delivery system reforms, and other reforms including the formation of ...


Data On Vietnamese Patients' Financial Burdens And Risk Of Destitution, Quan-Hoang Vuong, Trong-Khang Nguyen 2016 Universite Libre de Bruxelles

Data On Vietnamese Patients' Financial Burdens And Risk Of Destitution, Quan-Hoang Vuong, Trong-Khang Nguyen

Quan-Hoang Vuong

The research process started in the first week of August 10, 2014 and ended early February 2015, obtaining qualified data for 330 patients from many hospitals in northern Vietnam. Its expansion was performed for an enlarged dataset through May 2015, containing 900 records. This article exemplifies the attempt to examine the likelihood of destitution among Vietnamese patients due to insufficient insurance coverage, cost of treatment and patient׳s status of residency during a curative hospital stay. The result suggests that the patients, who are poor and come from rural areas, face serious obstacles in accessing health care services. This data ...


Car Rental Industry Fraud, Dennise Veasley 2016 La Salle University

Car Rental Industry Fraud, Dennise Veasley

Economic Crime Forensics Capstones

Fraud occurs in all industries and businesses large and small. The car rental industry is not immune to fraud. Fraud is committed by the owners and employees against the customers for personal or corporate gain. The car rental industry is considered a large business based on revenue of a minimum of $38.5 million dollars annually. (Electronic Code of Federal Regulations from http://www.ecfr.gov/) The car rental industry in the United States in 2015 grossed over $27.11 billion as defined by the market data for the U.S. Car Rental Market published by Auto Rental News (http ...


The Mystery Of Mutual Insurers In Lawyers Professional Liability Insurance, Tom Baker, Rick Swedloff 2016 University of Pennsylvania Law School

The Mystery Of Mutual Insurers In Lawyers Professional Liability Insurance, Tom Baker, Rick Swedloff

Faculty Scholarship

Large law firms in the U.S. rely heavily on lawyers-only mutual insurers to manage their malpractice risks. Yet, under classic economic theory, mutual insurers should not be able to compete with stock insurers, at least absent a market failure. Mutuals have less access to capital and thus less ability to spread risk. Also, mutuals demand much more law firm partner time. Our research into the lawyers’ professional liability (LPL) insurance market makes three contributions. First, while we find evidence consistent with the traditional explanations for mutual insurance—market failures related to moral hazard and adverse selection and a problem ...


Important Crop Insurance Dates, William M. Edwards 2016 Iowa State University

Important Crop Insurance Dates, William M. Edwards

william edwards

Even the best crop insurance plan is of little use if the right information is not collected and submitted on time. Likewise, if certain actions are not completed by the necessary date, producers may not receive full benefit from the risk protection that they have selected.


From Offline To Online: How Health Insurance Policies Drive The Demand For Online Healthcare Service?, Yue YU, Qiu-Yan MEI, QIU-HONG WANG 2016 Singapore Management University

From Offline To Online: How Health Insurance Policies Drive The Demand For Online Healthcare Service?, Yue Yu, Qiu-Yan Mei, Qiu-Hong Wang

Research Collection School Of Information Systems

Online healthcare service has gradually become a significant part of healthcare services, especially in emerging economy with shortage in medical resources and wide coverage in the Internet usage. This paper studies how health insurance policies affect the demand for online healthcare consultation by using longitudinal online healthcare and offline medical services datasets of a major city in China. The two policies we study are the integration of health insurance systems in urban and rural regions and the integration of health insurance systems between pairwise-cities. The empirical results show that both policies significantly affected the demand for online consultation. Our study ...


An Appraisal Of The Actuaries’ Climate Risk Index, Stephen Lee Kolk 2016 America Integrity Insurance Company

An Appraisal Of The Actuaries’ Climate Risk Index, Stephen Lee Kolk

May 18, 2016: The Economic Impacts of Sea-Level Rise in Hampton Roads

PDF of powerpoint presentation given at the workshop "The Economic Impacts of Sea-Level Rise in Hampton Roads: An Appraisal of the Projects Underway" on May 18, 2016 at the Virginia Modeling and Simulation Center, 1030 University Blvd, Suffolk, VA 23435


Why Not Fix It?, William H. Lane 2016 Gettysburg College

Why Not Fix It?, William H. Lane

English Faculty Publications

Have you felt the pinch of rising health care costs this year? If not, maybe you haven't actually needed to see a doctor or pay for a prescription. Even those of us who are lucky enough to be "covered" at work have noticed rapidly rising deductibles and copays - and shrinking networks of providers. Employers, facing a big, one-year increase in insurance costs, naturally enough go shopping for a new plan. But the big savings with a new plan often mean a big effective pay cut for everyone who's covered under it when employee contributions, deductibles and copays all ...


Confidence Band For Expectation Dependence With Applications, Xu GUO, Jingyuan LI 2016 Nanjing University of Aeronautics and Astronautics

Confidence Band For Expectation Dependence With Applications, Xu Guo, Jingyuan Li

Staff Publications

Motivated by the applications of the concept of expectation dependence in economics and finance, we propose a method to construct uniform confidence band for expectation dependence. It is derived based on Hoeffding’s inequality. Our proposed confidence band can be explicitly expressed and thus it is very easy to implement. Our method has applications to demand for a risky asset and first-order risk aversion problems. Simulations suggest our proposed confidence interval can control the coverage probabilities very well, and the average lengths are very short. Two empirical applications are presented to illustrate the usefulness of the constructed confidence band of ...


Do Health Insurers Innovate? Evidence From The Anatomy Of Physician Payments, Jeffrey Clemens, Joshua D. Gottlieb 2016 University of California - San Diego

Do Health Insurers Innovate? Evidence From The Anatomy Of Physician Payments, Jeffrey Clemens, Joshua D. Gottlieb

Joshua D. Gottlieb

One of private health insurers' unique roles in the United States is to negotiate physician payment rates on their customers' behalf. When it comes to these rates, do private insurers meaningfully differ from the large public insurer operating alongside them, or is the private sector–which appears so prominent–a mirage? We investigate the frequency with which privately negotiated payments deviate from the government benchmark using two empirical approaches. The first exploits changes in Medicare's payment rates and the second applies ideas from the bunching literature. Although Medicare's rates are influential, we find that prices for 25 percent ...


Black Box Thinking: Analysis Of A Service Outsourcing Case In Insurance, PAUL WITMAN, Christopher Njunge 2016 California Lutheran University

Black Box Thinking: Analysis Of A Service Outsourcing Case In Insurance, Paul Witman, Christopher Njunge

PAUL WITMAN

Case study on how to think critically about systems when one cannot "see" the inner workings of those systems, and about the impact of information systems on vulnerable populations.


Black Box Thinking: Analysis Of A Service Outsourcing Case In Insurance, PAUL WITMAN, Christopher Njunge 2016 California Lutheran University

Black Box Thinking: Analysis Of A Service Outsourcing Case In Insurance, Paul Witman, Christopher Njunge

PAUL WITMAN

Case study on how to think critically about systems when one cannot "see" the inner workings of those systems, and about the impact of information systems on vulnerable populations.


Pemco: We're A Lot Like You., Margaret Melville, Michael Viramontes, Thomas Stone, Jared Tate 2016 Brigham Young University

Pemco: We're A Lot Like You., Margaret Melville, Michael Viramontes, Thomas Stone, Jared Tate

MICCSR Presentations

No abstract provided.


Pemco: Corporate Social Responsibility, Frank Estevao Maia, Molham Krayem, Ha Young Shin, Erica Tsai 2016 Georgetown University

Pemco: Corporate Social Responsibility, Frank Estevao Maia, Molham Krayem, Ha Young Shin, Erica Tsai

MICCSR Presentations

No abstract provided.


Corporate Social Responsibility Strategy, Pemco Insurance, Conrad Nilsen, Emma Rabun, Joshua Schacht, Jaclyn Zalesky 2016 Gonzaga University

Corporate Social Responsibility Strategy, Pemco Insurance, Conrad Nilsen, Emma Rabun, Joshua Schacht, Jaclyn Zalesky

MICCSR Presentations

No abstract provided.


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