Description: Since health care reform has made accountable care organizations a hot topic, an SOA workgroup is addressing relevant questions, including provider risk under various ACO models, limitations of the Medicare model for motivating change in the health care delivery system, strategic priorities, attribution of members, meaurement, and the roles actuaries can play.

Description: This article compares July 1 renewal premium trends to January 1 renewal premium trends by benefit plan.

Description: A new initiative, Commercial Health Care: What’s Next, will focus on education and research for health actuaries regarding issues that remain with the ACA.

Description: Discusses various aspects of allowing a health insurance policy approved in one state to be sold in another state without the latter's approval or oversight.

Description: As private payers ponders the early adoption of genomic testing to guide treatment pathways, can personalized approaches to care prove financially sound?

Description: Collective Health plan sponsors found that concierge services and enhanced digital tools produced lower trend by helping members navigate more intelligently.

Description: Health Watch Newsletter, May 2006, Issue No. 52. This article presents information from a recently completed client-sponsored survey of hospital contracting best practices. Individual health plans were evaluated using a structured survey document. The primary objective of the survey was to identify best practices that the client sponsor could implement to improve its already better-than-average hospital contracting practices

Description: What is the difference between a Single-Payer and Universal Health Care System, and how could the U.S. implement a system that would reduce the growth of medical costs while increasing quality.

Description: On average, contracts receiving their first star rating receive 3.20 stars, compared to existing or established contracts receiving 3.90 stars on average. This 0.70 disparity in quality ratings creates significant hardship on new contracts when this lower star rating decreases their payments in the following calendar year. This article explores the disparity in Medicare Advantage Star Ratings between contracts receiving their first star ratings (“New” contracts) and existing contracts, including: 1. Understanding what happens to Medicare Advantage Payments when contracts receive lower star ratings? – What is the Star Rating cliff and why does it matter to new contracts? 2. Explaining when a contract receives their first star rating and how much enrollment this requires – When does the Star Rating cliff occur? 3. Noting which specific star measures “New” contracts struggle with, including those contracts under large parent organizations, contracts with rapid growth, and all other new contracts. – How can my contract avoid the Star Rating cliff?

Description: CHCS is a nonprofit policy center focused on improving American health outcomes, particularly for low-income people, including payment & delivery system reform.