Description: The presenters give a history lesson on the origin of CMS Medicare star ratings, including why this demonstration was originally created and how the program has worked over the years. The discussion will cover both the evolution of the underlying measures and the financial impact to Medicare Advantage stakeholders. By attending the session, you will have a stronger understanding of how member experience and outcome-based measures can be factored into the funding within a health care system to better align incentives among various stakeholders.

Description: Using data from the Health & Retirement Study [HRS], a two-part medical claim prediction model is estimated for a cohort of survey respondents approaching Medicare-eligibility age. A High Deductible Health Plan [HDHP] with a companion Health Savings Account [HSA] is applied to simulated claims streams to model the build-up of HSA assets over the near-retirement years. Results show that the HSA is a grossly inadequate savings vehicle to provide for retiree medical care expenses at age 65. Moreover, HSA adequacy worsens exponentially with diminishing health status. Based on this simulation, it is apparent that Baby Boomers cannot adequately provide for the costs of medical care in retirement using HSAs exclusively.

Description: The Individual Disability Experience Committee (IDEC) of the SOA has gathered industry data covering 2006-2015. This sessions will highlights their findings on the recent industry experience compared to the 2013 Individual Disability Income Valuation Table (2013 IDIVT), including the impact of the recession on incidence and terminations. The audience will gain an understanding of how the recent industry experience compares to the most recent valuation table. The session will cover claim incidence and claim termination Actual to Expected (A/E) using 2013 IDIVT as the expected basis. The adequacy of the modifiers will also be also be discussed.

Description: This discussion at the 1989 Valuation Actuary Symposium focuses on methods and considerations that are currently being used in analyzing various risks of concern to the health valuation actuary. The session looks at concepts and types of risks, considerations and influences affecting the actuary, formulas and methods for evaluating risk, and the present status of the health insurance valuation actuary concept.

Description: The article documents the efficacy of infra-low frequency neurofeedback regarding how it improves patient no show rates, decreases mental health symptoms by 40% or more, and self-harm and suicidal ideations.

Description: Explore the value and cost of prescription drugs, how they should be defined and measured and the effects various stakeholders in the pharmacy ecosystem can have on these factors in the latest webcast. You'll investigate the impact of coverage, formulary and rebate negotiations and related benefit design. Find out how actuaries can answer questions related to the prescription drug industry, in addition to improving the access, quality and affordability of prescription drugs in the United States. Join us for this webcast and come learn about value-based contract design, negotiations, implementation and administration for prescription drugs.

Description: A panel of actuaries and clinical consultants at this session of the SOA 2003 Vancouver Spring Meeting provides an assessment of current and future applications of predictive modeling techniques in the health arena. A practical example of risk adjustment, discussion of the clinical use of this technique, and applications in underwriting are discussed.

Description: This article provides an overview of critical illness insurance: history, product description, and the three primary ways to offer critical illness coverage in the United States. This article also contains an illustration of an issue age premium rate calculation, as well as product features and rating applications specific to the various types of critical illness coverage.

Description: Article reviews the data a year into the unwinding of continuous coverage provisions in Medicaid, the impact on enrollment counts, how capitation rates have been adjusted, and compares those results to what has been modeled with the SOA Mediciad Unwinding model.

Description: Considerations in the Development of Area Factors, Issue No. 38.