Description: An economics professor and a health care consumer advocate weigh in on the Patient Protection and Affordable Care Act, including implementation issues, directions for the future and what role actuaries shoudl take.

Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: The SOA analyzed Health Care Cost Institute (HCCI) claims data from 2009 – 2015 to better understand cost and utilization trends in the commercial health insurance market.

Description: Profile of the Health Section.

Description: The implications of the new long-term care law for individuals, employers, insurers and providers, and the federal government.

Description: The implications of the new long-term care law for individuals, employers, insurers and providers, and the federal government.

Description: Actuaries have the business acumen, problem-solving capabilities, and technical skills to develop innovative and data-driven solutions in the social insurance space. It is time we expand our scope and embrace an increased role in making a positive impact within the health care ecosystem. The primary focus of this paper is on social insurance programs dedicated to the most vulnerable population: low-income families accessing care through Medicaid. While there are numerous challenges that require other subject matter experts to take the lead, this article highlights topics where actuaries can be key players in developing and implementing tangible solutions to improve the care for the most vulnerable. Issues and solutions in this paper focus on the following three areas: 1. Access to appropriate care, 2. continuity of care, and 3. social determinants of health.

Description: Panelists at this session of the SOA 1989 Chicago Spring Meeting discuss Health Maintenance Organizaions [HMOs] including their hisotry, the marketplace, physician structures and relationships with HMOs, cost control issues and the future of HMOs.

Description: Considerable attention has been given in the recent past to the likely economic and social impact of Australia’s ageing population. One particular aspect which continues to be the subject of increased commentary and conjecture, is the need and subsequent costs for Long Term Care LTC. In this paper, a multiple state projection model based on a framework by Rickayzen and Walsh 2002 is constructed in order to project the number of people in Australia who are likely to require LTC.