This article focuses on the capitation rate development methodology for the Medicare-Medicaid Financial Alignment Demonstration. It also describes the background behind the establishment of the initiative and how it will be evaluated.

This article highlights several state's Medicaid innovatioins, including cutting edge payment changes based on episodes of care, patient outcomes, and quality metrics.

2010 Health Pricing Boot Camp: Medicare Track, Nov. 8- 9, 2010 - Session # 3. This presentation details an overview of the bid process, discussing separately HMO and SNP, local PPO, regional PO, and Private Fee for Service PFFS.

2010 Health Pricing Boot Camp: Medicare Track, Nov. 8- 9, 2010 - Session # 2. This presentation details the overview of the various product designs in Medicare Part C and the revenue paid to the Medicare Advantage Organizations MAOs both from the government and from member premiums.

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.

2010 Health Pricing Boot Camp: Medicare Track Nov. 8-9, 2010 , Session #10. Medicare Advantage plans are reimbursed by CMS on a risk adjusted basis for both Part C and Part D coverages. Going forward, there will also be adjustment for Quality STARS and new FFS relationships by region. This session will cover the basics of the Medicare risk adjustment models and the impact revenue to the plans. Additionally, we will discuss the impact of STARS and new FFS benchmarks to be gradually introduced in the next several years.

2010 Health Pricing Boot Camp: Medicare Track Nov. 8- 9, 2010 - Session 11. This presentation outlines the Medicare bid audit process.

2010 Health Pricing Boot Camp: Medicare Track Nov. 8- 9, 2010 - Session 8. This presentation details Medicare Part D, from terminology, bid process, to the PPACA impacts on Part D.

There is a wide range of literature on aging and health care. We sample this literature and find it fits into the subcategories of theoretical aging, medical significance of aging, treatment of the elderly, and resource allocation to the elderly. Themes are that financial arrangements can cause inefficient and ineffective care and that care guidelines need to developed specifically for the elderly rather than extrapolating guidelines for younger patients.

This study was sponsored by the Society of Actuaries Health Section. This paper explores the relative significance of aging as a determinant of financial cost of health care beyond age 50, with particular attention to the effect for ages 65 and older. The paper presents concepts of aging factors and aging curves, which define relative values between ages for utilization or cost of health care services. General conclusions are drawn from Medicare data that utilization and cost differ by age, but that aging factors vary across services and may be less significant at very old ages. The author then turns to the question of measuring the significance of an aging curve assumption and what accuracy is lost in the simpler alternative of a single value across an age range.