This session presents information on state initiatives on Medicaid and other topics.

In this session, a savings methodology framework will be presented, including the following topics: • Structure of savings certification process • Prospective vs. retrospective measurement • How actuarial techniques contribute to the process • Complex attribution and statistical modeling done by biostatistics area • Examples of basic and more complex savings calculations • Selection bias issues and how to address them.

May 2013 issue of the Health Watch newsletter

As providers are considering accountable and value based care models, it is critical to strategically think through how to achieve a sustainable business model into the future. This requires actuarial and clinical/provider capabilities to assess the care management and financial levers to help a client through the transition.

This article describes the results of three years of work by Blue Shield of California to collaborate with hospitals and physician organizations to reduce cost and improve quality for commercial populations in targeted geographies.

The article is a case study of various actuarial concepts invovled in the design and implementtion of the AQC - a global budget provider payment arrangement implemented by Blue Cross Blue Shield of MA.

The healthcare industry is in the middle of extraordinary times. This article outlines the many forces driving this transformation, as well as various obstacles. This has both personal and business implications to health actuaries.

Notes from the ACO Learning Network Webinar 5/16/2011. Covered overview and progress with the development of accountable care organizations, regulatory provisions that could be problematical and other implementation and viability issues.

Notes from the ACO Learning Network Webinar 5/26/2011. Covers the Medicare Shared Savings Program vs. the Pioneer program model, plus lessons from the Brookings-Dartmouth Center pilot sites.

This session presents case studies on accountable care organizations and primary care medical homes.