Health Research Reports

If you’re looking for research projects and reports on health topics, you’ve come to the right place. The SOA offers research, authored by an individual or a team of authors, for download in just a few clicks. Most reports are in PDF format.

Highlights of SOA Health Research Projects (August 2017)

2018

Examining Predictive Modeling-Based Approaches to Characterizing Health Care Fraud
March
The Health Section Research Committee is pleased to make available a research report providing a systematic evaluation of the modeling methodologies and data samples used to characterize health care fraud.
Model of Long-Term Health Care Cost Trends in Canada
March
The Canadian Institute of Actuaries (CIA) and the Society of Actuaries (SOA) are pleased to make available a resource model that provides long-run (to 2050 and beyond) forecasts of health care spending in Canada.
Provider Networks – Actuarial Perspective on Performance In and Out of Exchanges
March
The Health Section Research Committee and the Health Section are pleased to make available a research report describing aspects of provider network performance in health care settings with particular focus on experiences with Exchanges.
Actuarial Review of Insurer Insolvencies, Future Preventions
January
Sponsored by the Canadian Institute of Actuaries (CIA), Casualty Actuarial Society (CAS), and Society of Actuaries (SOA), this study looks at causes of insolvency and decisions made by management, regulators, and policyholders over the life cycle of the insolvency. This study is intended to educate insurance professionals on historical insurer impairments and insolvencies and possible future prevention indicators.
Insurance Risk and Its Impact on Provider Shared Risk Payment Models
January
The Society of Actuaries Health Section is pleased to make available a report examining the risk associated with the unpredictable variation in utilization and cost of services.
Analysis of Individual Disability Income Tables
January
The Society of Actuaries Health Section Research Committee is pleased to make available the first of two reports analyzing industry Individual Disability Income (IDI) claim incidence and termination experience trends relative to the 2013 IDI Valuation Table base incidence and termination rates. The first report covers claim incidence trends.

2017

Modeling Long Term Healthcare Cost Trends – Update for 2018
August
The Society of Actuaries' Pension Section and Health Section Research teams originally commissioned Professor Thomas E. Getzen of Temple University to construct a resource model for the projection of long term healthcare cost trends. The Society of Actuaries continues to make annual updates to the model to ensure its usefulness and relevancy.
Medicaid Managed Care Organizations: Considerations in Calculating Margin in Rate Setting
March
The Society of Actuaries Health Section Research Committee is pleased to make available a research report that describes the components of margin for calculating capitation rates in a Medicaid context along with a description of practical issues that may be encountered by MCO’s. The report includes observations from interviews with MCO executives as well as financial results analysis of MCOs nationwide.
Opioid Overdose Deaths in the United States
February
The Society of Actuaries is pleased to make available an article describing the demographics and geography of the increasing number of opioid deaths in the United States. The article summarizes data available from the Centers for Disease Control.
A Case Study of Risk Adjustment for Texas Medicaid
February
The Society of Actuaries Health Section is pleased to make available a research report that examines the impact on risk scores in risk adjustment models when there are timing differences for model updates of pharmacy data and risk factor mappings. The analysis was done through a case study of Texas Medicaid using the CDPS (Chronic Disability and Payment System) risk adjustment model.