Description: An analysis of prescription drug use in the Kansas individual market

Description: This is a final report to help individual health plans evaluate and manage their potential exposure during a specific pandemic. It examines the potential impact of pandemic influenza on different payers in the U.S. health care system.

Description: This section contains multiple book reviews and notices concerning the actuarial profession. Reviews: 'Medical Risks: Patterns of Mortality and Survival' by Singer and Levinson, 'The Theory and Practice of Pension Funding' by Trowbridge and Farr, 'Two Stochastic Processes' by Beekman, 'Disability Income Insurance - Cost Differentials between Men and Women' by New York Insurance Department, 'Social Security and Private Pension Plans: Competitive or Complementary' by McGill, 'A New Look at Accounting for Pension Costs' by Hall and Landsittel, '1977 Annual Reports of the Board of Trustees of the Federal OASDI Trust Funds...,' 'Investigation of Sickness Statistics - Individual Policies, 1971 and 1973' by the Institute of Actuaries and the Faculty of Actuaries, 'The Graduation of Pensioners and of Annuitants Mortality Experience 1967-70' by the Institute of Actuaries and the Faculty of Actuaries, 'Pensions and Survival - the Coming Crisis of Money and Retirement' by Calvert, 'Group Benefits in a Changing Society' by Spencer, 'Experience of Disabled Work Benefits under OASDI 1965-74' by Bayo and Wilkin. Digests also included.

Description: The purpose of this study is to evaluate the predictive accuracy of the commercially available claims-based risk assessment tools under different sets of conditions and with different sets of available information.

Description: This report presents the results of a study comparing health risk scoring models.

Description: Using the Health Care Cost Institute (HCCI) database, we examined which characteristics best predict and describe high-cost members.

Description: For the top-20 key risks, the carriers were asked to identify the key risk indicators (KRIs) they use for monitoring and the activities they use, or plan to use, to mitigate the likelihood of occurrence and/or the severity of impact.

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: In this, the second step, Sibson engaged the vendor and actuarial communities to solicit input on the actuarial model for determining the impact of various environmental, lifestyle and behavioral risk factors. The goal was to understand the extent to which actuaries currently use models around wellness, refine the above conceptual model, and better understand the potential uses of, and value to, the actuarial and vendor communities that would use such a model. We sought to understand the potential applications and sources of data for the actuarial model. We gathered input on how the model would best suit the professional needs and help shape the future role of the actuary. Lastly, we gathered feedback on the above conceptual model.

Description: The value-based ERM approach is a robust yet practical synthesis of enterprise risk management and value-based management, and has been used to help a range of companies – financial services companies, non-financial services companies, and non-corporate entities alike – successfully implement their ERM programs and integrate ERM into their decision-making processes.