Description: Actuaries have the business acumen, problem-solving capabilities, and technical skills to develop innovative and data-driven solutions in the social insurance space. It is time we expand our scope and embrace an increased role in making a positive impact within the health care ecosystem. The primary focus of this paper is on social insurance programs dedicated to the most vulnerable population: low-income families accessing care through Medicaid. While there are numerous challenges that require other subject matter experts to take the lead, this article highlights topics where actuaries can be key players in developing and implementing tangible solutions to improve the care for the most vulnerable. Issues and solutions in this paper focus on the following three areas: 1. Access to appropriate care, 2. continuity of care, and 3. social determinants of health.

Description: "The always popular Medicaid Hot Topics session is back with discussions from an expert panelist on the most riveting Medicaid topics of the year. These could include the following: • ACA court battles - what are the potential impacts on Medicaid? • CMS continues to open the door for state flexibility - just what can states now do differently?• Where are we on Medicaid work requirements? • How will the changes to the mega-rule impact Medicaid?• High cost drugs and how states are sharing risk for them (carve-out, risk pools, risk sharing)• And more current topics of interest to Medicaid actuaries!Medicaid is dynamic and it is difficult to stay up to date on all of the changes. This session provides insightful discussion into the major changes that impact actuaries and their companies or state clients"

Description: Interview of people knowledgeable about risk adjustment and the use of social determinants of health with that context for Medicaid.

Description: This article gives part of the testimony provided to a U.S. House Subcommittee about Medicaid abuse. Specifically, it explains how families with ample means are able to skirt the law and obtain Medicaid funding of nursing home care when private Long Term Care insurance should have been considered.

Description: Social Insurance & Public Finance Section council members provide a recap of sessions from the 2021 SOA Health Meeting, with a focus on sessions covering Medicare, Medicaid, the ACA, and public policy. The authors include a description of SIPF Section-sponsored sections, including a session on the ACA and a session on CMS's Direct Contracting Model.

Description: The traditional informal care of/by family has faced increasing geographic and economic challenges from changing family households and sources of family income. Financial planning and risk protection tools provide important resource in the changing retirement landscape toward optimal family support and crisis management, that is, with less duress and financial burden to affected family caregivers. Ultimately, maintaining family values and close communications through evolving family structures are key to a healthy society and economic welfare of the people.

Description: The article describes the sessions that the SIPF section sponsored - Paid Family Leave and Medicare and Medicaid Update. The Paid Family Leave session described what it is and what states it is currently in and how it is being implemented. The Medicare and Medicaid update gave the attendees the most up to date news about what is going on at the Federal level.

Description: The always popular Medicaid Hot Topics session is back with discussions from an expert panel on the most riveting Medicaid topics of the year. These could include the following: • Medicaid Fiscal Accountability Proposed Regulations• Tennessee's Block Grant Proposal• ACA court battles: What are the potential impacts on Medicaid? • Pass-through payments are converting to directed payments: What is changing?• And more current topics of interest to Medicaid actuariesMedicaid is dynamic and it is difficult to stay current on all of the changes. This session provides insightful discussion into the major changes that impact actuaries and their companies or state clients.

Description: This paper discusses the quality of healthcare verses the price of healthcare and puruses individuals and doctors making decisions for their own healthcare costs and services.

Description: A glossary of terms.