Description: Read detailed analysis of a legislated act aimed in providing access to affordable, quality, accountable health care.

Description: This article is focused on sustainability concerns in the ACA individual markets and what we can learn from core actuarial principles as discussed in ASOPs.

Description: 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.

Description: This article describes the Health Insurance Providers Fee implemented through Section 9010 of the Affordable Care Act (ACA) and discusses how the fee will creates challenges in Managed Medicaid Rate development. It also offers some suggested ways to include the fee in Managed Medicaid rates.

Description: This article discusses new opportunities for states to waive certain marketplace requirements of the Patient Protection and Affordable Care Act. The article focuses on specific opportunities for states and the role that actuaries will play.

Description: An overview of the issues behind reimbursing providers on a bundled or packaged basis. The article presents the potential advantages offered by the proponents as well as the criticisms and obstacles to implementing this type of payment system.

Description: Since health care reform has made accountable care organizations a hot topic, an SOA workgroup is addressing relevant questions, including provider risk under various ACO models, limitations of the Medicare model for motivating change in the health care delivery system, strategic priorities, attribution of members, meaurement, and the roles actuaries can play.

Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: We propose using premiums and tax revenue to fund high-cost individuals in the Individual ACA market.

Description: This paper will examine why CSR defunding produces pricing uncertainty and how regulators can alleviate these risks when insurers price 2020 premiums.