Description: A summary of the 14th Monograph “Health Risk Assessment and Health Risk Adjustment: Current Initiatives” published by The American Academy of Actuaries.'The monograph examines the approaches of two states, New York and California, in implementing or considering risk adjustment provisions in recent legislative reforms.'

Description: Health care reform will require health insurers to change the way they make decisions on what to sell while remaining financially sound. The new regulatory reality of expanded access to coverage leaves insurers with fewer options for managing costs and business risk. With the introduction of risk adjustment mechanisms in the exchanges, the most profitable members will not necessarily be the lowest cost ones, but rather, the members which the health plan is relatively more effective at servicing. While Patient Protection and Affordable Care Act 'PPACA' prohibits underwriting and using any health status information for denying coverage or varying the premium rates, this article describes how the use of consumer data will affect the way health insurers make decisions on what products to sell.

Description: This article is about the Balanced Budget Act of 1997. This Act revises the Medicare landscape by the creation of Part C - Medicare+Choice, Medical Savings Accounts, payment reforms.

Description: This article provides comments from leading health actuaries on Clinton's health care proposal.

Description: An editorial about the status of health care reform in the U.S.

Description: This article is about the very rapid pace of Health care reform on both the national and state level. The challenge is to ensure that viable financing vehicles are developed for cost effective health care delivery.

Description: This article provides a brief summary of the health insurance bill introduced in the New York legislature on February 22, 1967 which proposes mandatory heath insurance.

Description: This article presents the concept of comprehensive care management as a fundamentally different way to reform health care and reduce costs. There are 3 components - demand management, utilization management and disease management.

Description: This article explores what American medicine might look like in the year 2000. The author asserts this will depend on the tradeoffs made between quality and availability on the one hand, and cost on the other hand.

Description: This article discusses health care reform in Kentucky. In 1994, Kentucky implemented health care reform measures inspired by the unsuccessful attempt at national health care reform in the Health Security Act of 1993. The measures adopted in Kentucky are described by the author as 'a textbook case of how not to engage in health care reform.' From: The Actuary, April 2000 – volume 34 - Issue 4.