Description: This is the abstract for the paper, The Boomers Are Coming: A Total Cost of Care Model of the Impact of Population Aging on the Cost of Chronic and Acute Conditions in the United States. The complete paper is not available online.

Description: Savings from biosimilars have accelerated significantly in the past few years. There has been a number of relatively recent biosimilar launches that can help to shape our expectations of the financial impact that could result from this year’s big event. Savings from biosimilars have accelerated significantly in the past few years. There has been a number of relatively recent biosimilar launches that can help to shape our expectations of the financial impact that could result from this year’s big event.

Description: Prescribers, payers, and patients must put a higher priority on the comparative cost-effectiveness of competing pharmaceutical products if society is ever going to achieve rational and affordable drug use for all. From Prescription Drugs Monograph, M-HB04-1.

Description: Presented at the Living to 100 Symposium, January 2011. In India, the prevalence of lifestyle diseases such as diabetes and cardiovascular diseases has been increasing tremendously. This spurt of diseases and the resultant morbidity is severely affecting the quality of life of the elderly. The problem is compounded by a medical and health care infrastructure which is inadequate to meet the challenge. This paper analyzes and estimates, using actuarial tools, the effect on the economy with particular focus on the present and future elderly segment of the population, identifies opportunities for insurers to address the situation, and suggests remedial measures to deal with the situation. Medico-actuarial studies in this area will also be covered.

Description: HIV is still a big public health concern, but there are therapies available to prevent infection before and immediately after exposure. As legislatures and the USPSTF considers adding these therapies to the list of preventive care covered without cost share, actuaries will need to estimate the impact on their care cost. The presenters will share an actuarial tool kit to estimate the impact of covering PrEP and PEP for different populations. Examples are provided and discussion is welcome.

Description: The SOA’s research objective is to provide guidance to state exchange officials and administrators, federal officials and administrators, and actuaries assisting states and health plans. The goal of the project is to estimate the morbidity and/or cost for newly insured individuals in the individual market (and to some degree, the small group exchange) relative to the morbidity and/or cost for the current commercially insured population. This analysis will primarily focus on the individual, non-group market. In order to plan for the impact that these currently uninsured individuals will have on the health insurance markets, it will be important to understand their costs relative to the costs for people already enrolled, for whom many health insurers have experience and data.

Description: Panelists discuss the ongoing influence and long-term implications of the Health Insurance Portability and Accountability Act on the health insurance market in the U.S. From the Record of the Society of Actuaries, Vol. 24, No. 3.

Description: Article about the future roles in health insurance.

Description: An edited written interview with two actuaries and a public health professional on issues related to the intersection between the two fields.

Description: This analysis provides an overview of the functional components of the managed care system. It discusses the market forces underlying the United States’ system for health care financing and delivery and suggests how market forces impact the health care industry. The analysis focuses on societal goals for health care delivery and on managed care’s effectiveness in enabling achievement of those goals. The analysis develops and uses an innovative model developed to summarize the complex interplay among the many stakeholders, or participants, in the health care system. The model provides a framework for analysis of the many relationships among stakeholders. The analysis also highlights current issues in managed care, particularly the barriers that impede collaboration among stakeholders.