Description: This study aims to answer the question of how much of an episode’s cost and use of specific services can be attributed to the patient’s own health status, as opposed to being driven by other factors such as the care setting, patient preference, and provider practice patterns. In other words, do episode costs vary so widely because of patient characteristics, including health status, or are they related to other, nonclinical factors?

Description: This study used commercial data held by the Health Care Cost Institute (HCCI) and Medicare fee-for-service data to analyze health care cost differences by age and their contribution to overall health care cost change. The commercial data includes claims from 2002 through 2010 and the Medicare data includes claims from 2006 through 2010.

Description: This project shows how to use agent-based models to simulate the behaviors of agents in complex health systems.

Description: This session is geared to give participants a keener insight into the post September 11 factors underlying health care cost trends and how others in the industry view the future of health care costs. From the Record of the Society of Actuaries, Volume 28, No. 2, Session 4

Description: Discussion of the impact of the ACA on RBS and required surplus for a health plan

Description: An essay suggesting one solution in theory would be to create a system similar to Medicare Advantage for the entire American population.

Description: This session discussion is about development of medical cost estimates, differences between indemnity and HMO techniques, relationship of premiums and capitations, HMO organizational structures, experience rating, community rating and community rating by class. From Record of the Society of Actuaries 1987 Vol. 13, No. 1.

Description: Essay offers a vision of health care where everyone is covered, everyone is eligible, receives fair pricing, receives vital information and is taxed the same.

Description: This session discussed about expected trends in medical care costs, changes in Medicare reimbursement practices and their short- and long-term effects, the emerging responsibility for providing long-term care, rise of managed health care, new and old participants, selection issues, multiple options, and small group market.

Description: Recognizing the importance of fortifying risk adjustment programs against selection based on nontraditional variables, the Society of Actuaries’ Health Section sponsored an in-depth study into the relationship of nontraditional variables with health costs. This report presents the results of this study.