Description: Most health care delivered in the United States is based on the acute care model: it is episodic has a beginning, middle and end usually the patient recovers and interventions are designed to target a specific pathophysiologic abnormality. Chronic disease care, in contrast, often has no clear beginning and no end the focus is on managing over the long term with prevention of progression and complications. Further, many chronic diseases “travel together” comorbidities: for example, diabetes, hypertension, coronary artery disease CAD, heart failure, cerebrovascular disease, peripheral arterial disease and renal dysfunction are often found together.

Description: Essay states a competing American ideals for the U.S. Health care system include free markets which foster competition, cost effectiveness and quality health care vs.public and private assistance which provides health care independent of a person’s financial means.

Description: Health Watch, Issue 79, December 2015, Health Watch

Description: This article makes organizations entering the MA market aware of the star rating climate, as well as short- and long-term star rating & revenue considerations.

Description: Established as part of the 1998 Utah State legislative session, the State of Utah's Children's Health Insurance Program CHIP delivers much-needed health insurance to children that are not eligible for Medicaid and who are below certain poverty levels. From Prescription Drugs Monograph, M-HB04-1.

Description: Discusses management principles for the successful application of the underwriting processes of selecting and classifying risks and the actuarial pricing process of establishing adequate and equitable premiums for the risks to be underwritten within group medical business. Has some nice representative data for what a book of business might look like by case size.

Description: This is the abstract for the paper, The Need for Coordinated Care for Depression, and the Need for Creative Innovation by Stephen P. Melek, FSA.

Description: The article reviews high-deductible health plans and poor reimbursement for mental health providers as being the root of 3 devastating problems facing the US.