Description: ACA risk adjustment has now been in play for years. The original intent of risk adjustment was to help stabilize the market through measuring risk levels of each issuer. However, the risk adjustment program may have introduced additional uncertainty due to annual market shifts and model changes, making risk adjustment estimation is a difficult task. This article analyzes the results over time, including impacts from market changes and model changes.

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 MACRA/QPP Provider Revenue Model is designed to provide an estimate of the revenue impact of the QPP (MIPS, AAPM) on a provider group or ACO, based on the required inputs and scenarios.

Description: Discussion of recent developments in the taxation of noncoordinated benefits such as fixed indemnity, hospital indemnity, and specified disease insurance policies. Developments include a recent Chief Counsel Advice Memorandum and proposed triagency rulemaking that would impact non coordinated benefits.

Description: This is a brief report that summarizes recent changes in the prevalent medical loss ratio methodologies and also looks at some of the more recent experience of health insurers that filed medical loss ratio reports.

Description: An introduction to the ACA@10 Strategic Initiative, which examines the impact of the Affordable Care Act 10 years after its passage.

Description: The SOA is pleased to make available a research report providing insight and considerations for the actuarial profession in assessing the potential risk and opportunities of MACRA to both provider and payer organizations.

Description: This is a brief report that summarizes recent changes in the prevalent medical loss ratio methodologies and also looks at some of the more recent experience of health insurers that filed medical loss ratio reports.

Description: This session will present the findings published in the report released by the SOA on the March 23, 2020, the 10th anniversary of the ACA.This session will provide an assessment and commentary on the viability of the individual and Medicaid marketplaces under the ACA since its inception. Observations will be based on a data-driven analysis of the associations between market characteristics and measureable outcomes indicative of viability. Viability will be measured in the context of achieving the ACA's goal of providing sustainable access to affordable healthcare to the uninsured and underinsured, and will be considered from the perspectives of various stakeholders.