Health Insurance terms: http://www.bls.gov/ncs/ebs/sp/healthterms.pdf The 3 Rs of the Affordable Care Act: http://www.commonwealthfund.org/publications/blog/2014/mar/the-three-rs-of-health-insurance Here are some other resources online: http://chir.georgetown.edu/health_insurance_101.html http://www.bcbsfl.com/wps/wcm/connect/dcf221c1-bad8-4b3a-91ff-e0dbee350bbd/02-10-14+Health+insurance+terms+101.pdf http://www.cms.gov/CCIIO/resources/files/downloads/uniform-glossary-final.pdf Subscribe to these newsletters and read content on the website: http://www.healthcarepayernews.com/ http://www.healthdatamanagement.com/ Good book on the US Healthcare system: http://www.amazon.com/Health-Care-USA-Understanding-Organization/dp/0763784583 45 million in medicare, about 15m in Part C Medicare Part, A, B, C, D Medicare advantage Part C delivered by Anthem Difference b/w Part C & Medicare supplemental policy Some people buy a supplemental policy which is not covered by Part B & D Look up coordination of benefit Medicare Medicaid dual eligible Medicaid Managed Regular Funding mechanisms Obama care expansions Lookup Coordination of Benefits for Medicare or Medicaid About 9m people who are dual eligible - very high cost because they are very sick people As whole the insured population is going to be expanded, Medicaid expansion & Medicare Advantage is where the money is Read about Medicare risk adjustment & Medicaid Risk Adjustment (this is what helps get more money from Govt). This is where the clinical data helps. Clinical data will help build the risk model for individual.