Description: This is the inventory part of the report from the research project that reviewed and inventoried the range of quality and efficiency measures currently available for healthcare. The goal was to outline key areas of quality and efficiency measurement and identify future opportunities for actuaries. The inventory lists the resources and provides brief descriptions of their services with links.

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: A Regulatory Perspective on Rate Review Before and After the Affordable Care Act

Description: Essential Health Benefits and Actuarial Value

Description: Medicare Advantage and ACA

Description: Presentation at October 1985 Annual Meeting. This session will discuss trends in medical technology as they affect health care benefits programs, including: life extension, organ transplants, high-cost procedures, and plan design.

Description: Panel discussion, by a physician and an actuary, about the historical forces behind various trends in organ transplant experience data.

Description: In this session, panelists present their views on the future of managed care in light of the current environment. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 118

Description: This article reviews Canada's Medicare Plan, the Chaoulli Supreme Court decision and looks at factors affecting waiting times. From Health Watch Newsletter, May 2006, Issue No. 52.

Description: The purpose of this project was to create a tool that would allow actuaries to derive an understanding of the evidence for medical technologies that are provided through health plans.