Description: Risk adjusters were first used for the Y2K reimbursements to Medicare+Choice laws. How did plans fare? What was the financial impact to the Medicare program? What changes are expected for the future? From Record of Society of Actuaries, Volume 26, No. 1. From Record of Society of Actuaries, Volume 26, No. 1: Las Vegas Spring Meeting, May 22-24, 2000, Session 125PD.

Description: Summary of testimony by an AAA Board member before a congressional subcommittee, as an expert on risk assessment and adjustment, especially in relation to Medicare risk contracting and HMO payments. She recommended: mitigating the geographical region values, credibility weights for payments to health plans, carving out high cost claim segments, reengineering the ACR methodology, shifting AAPCC methodology from fee-for-service toward competitive bidding, and further projects to improve risk methods.

Description: Presented at May 2000 Spring Meeting. The Balanced Budget Act of 1997 dramatically changes the competitive landscape for Medicare products by establishing the Medicare+Choice program. This session recaps the Balanced Budget Act's impact on payment rates for capitated plans and the effects that the changes have made on benefit design and enrollment trends in certain geographical areas.

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: There is a wide range of literature on aging and health care. We sample this literature and find it fits into the subcategories of theoretical aging, medical significance of aging, treatment of the elderly, and resource allocation to the elderly. Themes are that financial arrangements can cause inefficient and ineffective care and that care guidelines need to developed specifically for the elderly rather than extrapolating guidelines for younger patients.

Description: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate and influence health care policymakers on issues including principles for health care reform, Medicare, wellness programs, and solvency.

Description: This article examines the concept of Actuarial Value, especially as it applies to the Medicare plan of benefits. It discusses the cost-sharing responsibility of Medicare beneficiaries and the means by which they mitigate this risk.

Description: The moderator will review senior health products: Medicare supplement, Medicare risk, hospital indemnity policy HIP, cancer, accidental death AD, and employer continuance. Discussion will include product design, pricing, administration, regulation, and marketing. From the Record of the Society of Actuaries, Vol. 21, No. 1.

Description: This study was sponsored by the Society of Actuaries Health Section. This paper explores the relative significance of aging as a determinant of financial cost of health care beyond age 50, with particular attention to the effect for ages 65 and older. The paper presents concepts of aging factors and aging curves, which define relative values between ages for utilization or cost of health care services. General conclusions are drawn from Medicare data that utilization and cost differ by age, but that aging factors vary across services and may be less significant at very old ages. The author then turns to the question of measuring the significance of an aging curve assumption and what accuracy is lost in the simpler alternative of a single value across an age range.

Description: The American Academy of Actuaries is engaged in several projects that proactively examine the future status of the Medicare Program. This session presents the findings that have resulted from these efforts. From the Record of the Society of Actuaries, Vol. 24, No. 2.