Description: On March 6, 2023, The Wall Street Journal hosted its Health Forum, a hybrid all-day event. The virtual meeting featured 11 different events. This white paper focuses on those events. The sessions were informative and fast-paced, with each one providing a quick hit of relevant and cutting-edge information around health care.

Description: Chapter 3 describes the methods and data being used in the evaluation predictive accuracy. From A Comparative Analysis of Methods of Health Risk Assessment, M-HB96-1.

Description: Disease management DM is increasingly encountered in health plans and employer groups as a health care intervention targeted to individuals with chronic diseases chronics. The untested assumption is that without DM, the chronic and non-chronic trends are identical. From Financing Chronic Care Monograph, M-HB05-1.

Description: Changes introduced by various Medicare Alternative Payment Models and the Medicare Access and CHIP Reauthorization Act (MACRA) have accelerated an existing market trend of shifting some of what has traditionally been considered “insurance risk” to providers. The Provider Risk Sharing Boot Camp will give attendees deeper insights into methods, current thinking, and alternative solutions that actuaries can use to help providers understand and manage the financial and actuarial risks that they are taking, many for the first time.

Description: The recent outbreak of the Zika virus (ZIKV) in Brazil and in at least 29 other countries and territories is a stark reminder of the risks associated with new, emerging and reemerging infectious diseases. This article is intended to provide essential background information on the Zika virus in order to assist insurers’ understanding and risk assessment of the situation. Insurers must continually stay abreast of these risks and rapidly assess the potential impact on morbidity and mortality – often with only preliminary scientific or actuarial data

Description: A discussion of permissible use and collection of genetic information for Health Risk Assessments and wellness programs under the Genetic Information Nondiscrimination Act of 2008.

Description: We propose using premiums and tax revenue to fund high-cost individuals in the Individual ACA market.

Description: This document provides an explanation of the Health Company Pandemic Modeling tool excel workbook and gives step by step instructions for companies to enter specific scenarios and assumptions.

Description: Article from The Actuary, April 1972 – volume 6 - Issue 4 is a review of a book by Lewis C. Robbins, M.D., M.P.H. and Jack H. Hall, A.B., M.D., titled How To Practice Prospective Medicine by assessing and classifying various health risk factors. The review states the authors' basic assumption that average risk can be determined by calculating the total numbers of deaths by cause in the general population is open to criticism. Furthermore, the assignment of weights for the individual risk factors is quite tenuous in many instances. The authors acknowledge this, but once a number appears in print, especially as part of a complex table, it achieves a sanctity that is difficult to destroy.

Description: The PPACA imposed a market share-based health insurance provider fee, known as the "Section 9010 Fee", "Health Insurer Fee", or simply the "HIF", on each “covered entity” with net premiums written in excess of $25 million that is engaged in the business of providing health insurance coverage for U.S. health risks. This article provides background information to help unpack the language behind the Section 9010 Fee and highlights a few areas of special interest including merger and acquisition-related issues, application of the Section 9010 fee to expatriate plans, and considerations regarding fee administration.