Description: Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the member and increased payments to Medicare Advantage plans. Milliman's HCC prevalence study illustrates the significant variations in HCC prevalence rates by age/gender, geography, and population type and will assist plans in benchmarking the effectiveness of their own diagnosis code capture efforts.

Description: Changes introduced by various Medicare Alternative Payment Models and the Medicare Access and CHIP Reauthorization Act (MACRA) have accelerated an existing market trend of shifting some of what has traditionally been considered “insurance risk” to providers. The Provider Risk Sharing Boot Camp will give attendees deeper insights into methods, current thinking, and alternative solutions that actuaries can use to help providers understand and manage the financial and actuarial risks that they are taking, many for the first time.

Description: This paper reviews the geriatric literature to identify risk factors that could be used by insurers to identify existing or incipient frailty.

Description: This document provides an explanation of the Health Company Pandemic Modeling tool excel workbook and gives step by step instructions for companies to enter specific scenarios and assumptions.

Description: Submission components, format and considerations.

Description: Presented at Living to 100 symposium January 2002. This paper evaluates age and sex specific patterns of change in underlying and multiple cause of death reports for the period 1980-1998 for 14 leading causes of death at ages 65 and older. Changes in four types of mortality measures will be analyzed: 1 underlying cause death rates 2 multiple cause death rates 3 associated cause death rates and 4 death rates based on the joint occurrences of multiple cause conditions. Implications of the results are discussed in the context of existing models for analyzing and forecasting future mortality patterns in the U.S.

Description: This is an abstract for the paper, Analysis of Costs for a Chronic Disease with Acute High Cost Episodes by Marjorie Rosenberg and Philip Farrell.

Description: Discusses types and methods of analysis of morbidity experience, reserves, and policy form drafting issues.

Description: Successful healthcare reform: First, it must help that must keep healthy people healthy. Second, it must help people mitigate or eliminate the health-risks associated with unhealthy lifestyle behavior choices, and Third, it must ensure the provision of evidence-based care to those who are ill.