Description: Medicare Advantage and ACA

Description: This session discussion is about managed mental health, substance abuse, prescription drug, and vision benefits. From Record of Society of Actuaries Vol. 19, No. 1B.

Description: Disease management DM is increasingly encountered in health plans and employer groups as a health care intervention targeted to individuals with chronic diseases chronics. The untested assumption is that without DM, the chronic and non-chronic trends are identical. From Financing Chronic Care Monograph, M-HB05-1.

Description: Taxes and Fees Introduced by the ACA

Description: Actuaries should understand the economic considerations involved in the formulary drug decision-making process, and the presence of actuarial input in the process could improve it, especially by tying it to overall decision making for the health plan. From Prescription Drugs Monograph, M-HB04-1.

Description: In the course of consulting engagements, actuaries almost always find they need one or more of the following resources: -Healthcare data, which may be at the individual patient level or on a particular population. -Health services research studies which describe, summarize, try to alter, or predict patients’ use of health resources. -Health policy information, which describe public or private actions which affect the access, cost and quality of medical care. This document describes the ever-changing resources and specifies where they may be obtained.

Description: Introduction to the ACA @ 5 publication

Description: A compilation of feedback from actuaries in the Health Section of the affects of the ACA.

Description: Epilogue to ACA@5 publication

Description: This article focuses on the actuarial value calculator and the methodology used. It proposes potential future improvements to this model.