Description: A proposal to reform the health care provider payment system through: a national fee schedule, shifting more reimbursements to primary care providers, better integration of hospital & physician fees, evidence based care, pay for performance, and a better provider risk sharing mechanism.

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 healthcare industry is in the middle of extraordinary times. This article outlines the many forces driving this transformation, as well as various obstacles. This has both personal and business implications to health actuaries.

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: The Health Section Council Chairperson looks back at a historic year for the health care industry, and what it means for health actuaries.

Description: A report on the proceedings of the June 2010 SOA health meeting. Leading topics included health care reform, opportunities to expand actuaries' roles, the global financial crisis, and collaboration with other organizations.

Description: The editors of Health Watch have made health care reform the focus of the Sepctember 2009 issue, and provide an introduction to the issue's contents.

Description: Mental health spending has reached $147 billion in the United States with demand only increasing greatly impacting society as nearly 1 in 5 experience these issues. There are even more indirect costs associated with mental health causing a national crisis surpassing 1 percent of the GDP. These costs coupled with the severe lack of licensed clinicians calls for an innovative solution. Through years of development and completion of a randomized controlled trial, Prevail has built and validated a low-cost, scalable solution. Prevail's clinically proven digital mental health treatment provides increased access to care while reducing overall health costs. Private and public payors should being reimbursing this model and offering it to their members.

Description: An overview of the issues behind reimbursing providers on a bundled or packaged basis. The article presents the potential advantages offered by the proponents as well as the criticisms and obstacles to implementing this type of payment system.

Description: A review of the 2009 Health Spring Meeting, which included speakers & sessions on the future of the SOA, U.S. health care reform, claims data issues & improvements, predictive modeling, underwriting principles, employer stoploss, cost trends, LTD & disability, and mental health parity regulations.