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

Description: Panelists discuss various legislative activities at the federal and state levels that affect health organizations doing business in the commercial market including: patient protection, uninsured, coverage mandates, genetic testing and mental health parity. Also included are case studies of New Jersey and New York's approach to coverage for the uninsured. From the Record of the Society of Actuaries, Volume 28, No. 3, Session 80

Description: This article contains excerpts from the first three articles that were released through the strategic initiative - Commercial Health Care: What’s Next?

Description: As providers are considering accountable and value based care models, it is critical to strategically think through how to achieve a sustainable business model into the future. This requires actuarial and clinical/provider capabilities to assess the care management and financial levers to help a client through the transition.

Description: This article summarizes the presentations by the Society of Actuaries and the Academy of Actuaries at the January 2015 National Academy of Social Insurance (NASI) Roundtables in Washington DC. SOA presented on the 2014 SOA monograph series "The Link between Retirement Security and Long-Term Care."

Description: Mental health spending has reached $147 billion in the United States with demand only increasing greatly impacting society as nearly 1 in 5 experience these issues. There are even more indirect costs associated with mental health causing a national crisis surpassing 1 percent of the GDP. These costs coupled with the severe lack of licensed clinicians calls for an innovative solution. Through years of development and completion of a randomized controlled trial, Prevail has built and validated a low-cost, scalable solution. Prevail's clinically proven digital mental health treatment provides increased access to care while reducing overall health costs. Private and public payors should being reimbursing this model and offering it to their members.

Description: An actuarial model that provides financial incentives to providers to offer patients an approach that can reverse chronic disease and reduce health care costs

Description: This article, an Honorable Mention Essay for the Society of Actuaries' Entrepreneurial Actuaries Section 2010 Papers Competition, is a discussion of the various issues relating to measurement of data in healthcare. The author presents “a light hearted & tongue-in-cheek take on how healthcare is typically measured, and an entrepreneurial vision for a better world.” Noting that typically data is summarized in deterministic models that produce point estimates for analysis and decision making, the author’s vision presented in the paper “is that of a central repository of actuarially modeled distributions that can either be used as benchmarks or adapted to an organization's experience.”

Description: This session is about the details of the inception and implementation of the Oregon Health Plan. From Record of Society of Actuaries Vol. 18, No. 1B.