Description: Introduce basic concepts of the Health Risk-Based Capital and show case a few strategies around Risk-Based Capital.

Description: Analysis of the impact of disease progression and treatment on life expectancy provides perspective on the long term costs to the health care system of chronic medical conditions.

Description: Issues relating to the1998 Balanced Budget Act BBA on Medicare Supplement Carriers. Discusses High-Deductible options, open enrollment provisions, pre-existing condition limitations, new provider payment methods and preventive benefits Issue No. 36.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: This article is based on a third party administrator study and explores the relationships between family structure, spare capacity and health care utilization.

Description: This article reviews the Medicare Prescription Drug, Improvement and Modernization Act and the impact the legislation has had on Medicare Supplement plans, policies and the changes to the model regulation. From Health Section Newsletter, March 2005, Issue No. 49.

Description: Corporate Economist for Humana describes the process of relating the macroeconomy to trends in health care claims. Rather than omit the economy's influence, or ascribing it to another source, forecast accuracy is improved by explicitly incorporating macro trends after actuarial components are removed. Success in this endeavor depends on deep knowledge and experience with both econometric forecasting and the health care industry.

Description: Improve pharmacy cost forecasting by developing induced demand curves for pharmacy costs.

Description: This article provides an introduction to the Medicare Prescription Drug, Improvement and Modernization Act of 2003 and looks at how the Medicare prescription drug plan will affect the commercial market as well as, what PDPs will offer for benefits and if any will offer supplemental benefits. From Health Section News, March 2005, Issue No. 49.

Description: Overview of a benefit rush and its effects on companies.