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Watson Health Care Case Study

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Hello Ms.Taylor and Ms. Partyka,

Thank you so much for the offer to become an IBMer in this Watson Health Analytic Consultant role. I accept this offer and its conditions which were included in the .pdf offer letter through my Career Portal. I am excited to join the team in Chicago and I believe that June 5th, 2018 will be a good starting date for me if possible.
The rising cost of healthcare is an issue that has long been addressed through rate review by the Insurance Division. Based on projections of premiums in the State of Hawaii for the next ten to twenty years alone, health care premiums alone will account for over thirty percent of a family of four’s household income. The yearly premium increases consider the total amount an insurer reimburses a medical provider for claims submitted. The purpose of this study is to identify the top healthcare cost drivers by ICD …show more content…
Health Branch requested the insurers provide aggregate data of total billed claims, paid claims, covered lives, and member-months that were stratified by gender, age, plan type, and year. Age was reported as ten-year categories. Plan type was defined as plans sold on the commercial market, which include EUTF and Federal plans. The plan types include: all individual plans sold on the ACA marketplace and off the marketplace; all grandfathered, transitional, and ACA compliant plans in the small group market; all grandfathered, transitional, and ACA compliant plans in the large group market. The data requested was for the years 2014 through 2016. Total billed claim was defined as the total amount of a claim submitted by a medical provider to an insurer. Total paid claim was defined as the total amount paid to the medical provider by the insurer. A per member per month (PMPM) cost was calculated by taking the total ICD paid and billed amounts and dividing each by the total member months for each

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