Description: This report summarizes a study that estimates the total economic burden of the opioid crisis in the United States from 2015 through 2018 and projects future costs of the opioid epidemic for 2019.

Description: Presented at April 1986 Spring Meeting. This session discussion is about the techniques for understanding and analyzing trends in medical care, including: utilization and cost components, analysis of cyclical behavior, use of econometric models, and aggregate trend vs. employer-specific needs.

Description: Describes a process to develop a good forecast. Also provides an example.

Description: The concept of Value Added [based on Embedded Value] is discussed in detail, from theory to implementation, pros and cons, and how it works in practice. Session 11 of the 1991 Valuation Actuary Symposium.

Description: A number of insurance companies have recently implemented, or are in the process of implementing, economic risk capital. These programs are being implemented because of concerns with the existing regulatory and accounting frameworks and/or companies' desire to have a capital framework which is more consistent with their risk profile. From the Record of the Society of Actuaries, Volume 30, No. 2, Spring Meeting, San Antonio, TX, June 14-15, 2004, Session 47PD.

Description: The level-funding approach to medical stop-loss insurance is growing in popularity, yet is highly specialized. This session will give the actuarial community an overview of level-funding, including the basic mechanics, the benefits of offering level-funding to clients, and the five keys to success, including the ability to underwrite this specialized coverage.

Description: This discussion looks at the causes of the increase of costs in medical care and what can be done to keep these costs under control. Form Transactions of Society of Actuaries 1959, Vol. 11, No. 30 AB.

Description: This session explores the far-reaching changes to how clinical data will be sourced, processed and consumed in many payer use cases including risk adjustment, quality measurement, care management, claims adjudication, prior authorizations, and other payer functions. Robust, interoperable data exchange is a prerequisite for value-based care. Clinical data will be increasingly accessible to augment administrative (claims) data via standardized Fast Health Interoperability Resources (FHIR, pronounced 'fire'), at a fraction of the cost of a accessing a traditional medical record and in real-time. On May 1, 2020, HHS issued a final rule implementing interoperability and the patient access provisions of the 21st Century Cures Act of 2016, although enforcement has been delayed into 2021 because of the COVID-19 pandemic. The new regulations promote, “HHS’s vision and strategy for achieving a health information ecosystem within which all individuals, their personal representatives, their health care providers, and their payers are able to send, receive, find, and use electronic health information in a manner that is appropriate, secure, timely, and reliable to support the health and wellness of individuals through informed, shared decision-making, as well as to support consumer choice of payers and providers.”Once enforcement begins, CMS and the Office of the National Coordinator for Health Information Technology (ONC), have the authority to mandate adoption of interoperability requirements, and also penalize payers and providers for non-compliance or the delay and withholding of data.This ‘digital transformation’ of the clinical data ecosystem has far-reaching implications for enabling technologies including Natural Language Processing (NLP) and entire segments of services and vendors. It will eliminate many departmental barriers, duplication and error sources for health plans and impact every department and the underlying economics of delivering and managing care.

Description: Panelists at this session of the SOA 2001 Toronto Spring Meeting discuss new profit measures that are used in the management of the company. The focus is on value-added and risk-adjusted return on capital [RAROC] methods.