Description: This article summarizes 2012 AAA activities relating to the Affordable Care Act implementation, including work on the Amicus Brief for the Supreme Court Decision, MLR regulations, Actuarial Value, Rate Review, Essential Health Benefits and work with the NAIC.

Description: This article is based on a third party administrator study and explores the relationships between family structure, spare capacity and health care utilization.

Description: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate health care policymakers on issues including health care reform, Medicare, loss ratios, premium review, reinsurance, benefit and eligibility changes, exchanges, and risk based capital.

Description: The big event of 2023 is the launch of multiple Humira biosimilars, which began in January with the arrival of Amgen’s Amjevita on the market. The launch of Amjevita kicks off the process of changing the specialty drug marketplace in the United States. The expectation of the full impact of this big event is very hopeful, but there is still uncertainty several months after its beginning. Humira is the highest-selling drug in the world and has been since 2013 (Figure 1)—except for when COVID-19 projects temporarily surpassed it. The world is eagerly awaiting the launch of multiple biosimilar drugs to compete with Humira and hopefully bring more competitive pricing to the benefit of payers and patients everywhere.

Description: Savings from biosimilars have accelerated significantly in the past few years. There has been a number of relatively recent biosimilar launches that can help to shape our expectations of the financial impact that could result from this year’s big event. Savings from biosimilars have accelerated significantly in the past few years. There has been a number of relatively recent biosimilar launches that can help to shape our expectations of the financial impact that could result from this year’s big event.

Description: Update on Health Section research projects and topics, including new vision and mission statements for the Health Section Council, research and communications projects, and information about the Health Actuarial Research Initiative.

Description: This article contains excerpts from the first three articles that were released through the strategic initiative - Commercial Health Care: What’s Next?

Description: Mental health spending has reached $147 billion in the United States with demand only increasing greatly impacting society as nearly 1 in 5 experience these issues. There are even more indirect costs associated with mental health causing a national crisis surpassing 1 percent of the GDP. These costs coupled with the severe lack of licensed clinicians calls for an innovative solution. Through years of development and completion of a randomized controlled trial, Prevail has built and validated a low-cost, scalable solution. Prevail's clinically proven digital mental health treatment provides increased access to care while reducing overall health costs. Private and public payors should being reimbursing this model and offering it to their members.

Description: Toole encourages actuaries to volunteer for local public health departments.

Description: This article discusses new opportunities for states to waive certain marketplace requirements of the Patient Protection and Affordable Care Act. The article focuses on specific opportunities for states and the role that actuaries will play.