Description: Methods and assumptions used in the valuation of savings by external care vendors

Description: Essays show a new system that will encompass minor changes to the current health insurance system, it will allow consumers to sign up for Federal Employees Health Benefit Plan and be administered like Medicare but with more benefits and emphasis on preventive care.

Description: Strategies to position Medicare Advantage plans for success during August resubmission.

Description: This article provides the perspective of the Health Section's chairperson on Section activities, educational programs and the US healthcare environment.

Description: Presenter examines federal and state efforts at parity in the area of mental health insurance. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: Panelists discuss the role of the valuation actuary in health insurance. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: Med Supp

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: Examines the question of whether health-care costs, or health insurance costs, are in crisis.

Description: Essay where payers desiring to optimize health gains per dollar spent should avoid “across the board” cost sharing, and instead implement a “value based” design that removes barriers/provides incentives to encourage desired behaviors for patients and providers.