Description: This analysis provides an overview of the functional components of the managed care system. It discusses the market forces underlying the United States’ system for health care financing and delivery and suggests how market forces impact the health care industry. The analysis focuses on societal goals for health care delivery and on managed care’s effectiveness in enabling achievement of those goals. The analysis develops and uses an innovative model developed to summarize the complex interplay among the many stakeholders, or participants, in the health care system. The model provides a framework for analysis of the many relationships among stakeholders. The analysis also highlights current issues in managed care, particularly the barriers that impede collaboration among stakeholders.

Description: In the course of consulting engagements, actuaries almost always find they need one or more of the following resources: -Healthcare data, which may be at the individual patient level or on a particular population. -Health services research studies which describe, summarize, try to alter, or predict patients’ use of health resources. -Health policy information, which describe public or private actions which affect the access, cost and quality of medical care. This document describes the ever-changing resources and specifies where they may be obtained.

Description: Actuary Dave Dillon describes his role volunteering his time as a teacher in higher education, including the rewards and challenges that teaching offers. He discusses the importance of being attentive to his audience’s pre-existing knowledge and adapting his presentations accordingly. His work as a teacher typically encompasses three distinct domains: 1) acquainting young students with the actuarial profession, 2) educating non-actuaries about public policy issues related to health insurance (including the Affordable Care Act), and 3) instructing current actuaries on advanced methodologies and principles within the field. Recently he taught a health insurance course for actuarial science graduate students at Georgia State University and lectured at Boise State University’s master's program in Population & Health Systems Management. In every teaching and mentoring opportunity, actuaries can contribute to the expansion and prosperity of the profession and are encouraged to pursue these endeavors.

Description: This is an article providing a summary of the SOA Research Institute's participation in an NAIC meeting that took place in December 2022. This article will also be disseminated via the SOA News Weekly, linking to the article posted on soa.org.

Description: An article recapping the SOA's participation in the NAIC Summer 2023 meeting.

Description: LEARN is an offering to regulators about reinsurance. This article summarizes a session held for Brazilian health regulators in the fall of 2022.