Description: A divisive confrontation over health care pricing is almost inevitable over the next few years. What will ultimately happen is a political decision, not an actuarial one—but it will have major consequences for the trend in health care costs and the divergence between public and private insurance premiums.

Description: In the past months, as COVID-19 has forced the reduced activity in the U.S. economy there has been some very substantial, but varied effects on the U.S. healthcare system. There is a lot of potential for confusion amongst providers and patients with regards to decisions related to which services ought to be rendered and which ought to be deferred. Two specific agencies – the Centers for Medicare and Medicaid Services (CMS), and the American College of Surgeons (ACS) have put together some guidance to add more clarity towards what types of services should be provided and what types ought to be deferred. In addition, this paper includes a discussion on what types of services are most likely to be deferred, and which ones will accrue pent-up demand to be released when many of the deferred services become available again.

Description: In this report, we explore the impact of clustering using the Medical Expenditure Panel Study (MEPS) data for children (aged 5 to 17) to build a bridge between oral health and overall health using dental and medical expenditures. We include social determinants of health as cluster input variables using the Partitioning around Medoids (PAM) method to identify children and their families who could potentially benefit from population health management related to oral health.

Description: This panel discusses the new customers, new forms of risk-sharing and new ways of reinsuring these risks. It also looks at the future in this rapidly changing market. From Record of Society of Actuaries, Vol. 22, No. 2.

Description: 2021 ImpACT Conference - Session 12A: Rural Health Care 10.29.21 Recording

Description: 2021 ImpACT Conference - Session 5C: Transforming Health Insurance Through Consumer-Centric Products 10.26.21 Recording

Description: In the past months, as COVID-19 has forced the reduced activity in the U.S. economy there has been some very substantial, but varied effects on the U.S. healthcare system. There is a lot of potential for confusion amongst providers and patients with regards to decisions related to which services ought to be rendered and which ought to be deferred. Two specific agencies – the Centers for Medicare and Medicaid Services (CMS), and the American College of Surgeons (ACS) have put together some guidance to add more clarity towards what types of services should be provided and what types ought to be deferred. In addition, this paper includes a discussion on what types of services are most likely to be deferred, and which ones will accrue pent-up demand to be released when many of the deferred services become available again.

Description: 2021 ImpACT Conference - Session 7B: Premium Alignment in ACA Markets: New Trends in State Guidance 10.27.21 Recording

Description: 2021 ImpACT Conference - Session 13A: The Chronic Disease Burden: Beyond the Awareness Ribbons 10.29.21 Recording

Description: The June 2021 Supreme Court ruling in California vs. Texas has significant ramifications on Affordable Care Act markets. This session will provide the actuarial community an overview of the ruling, the likely impact on health insurance markets, and potential legislation to address the ruling details.