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: Many executives are talking about predictive analytics uses in health insurance.

Description: Health Watch, Issue 79, December 2015, Health Watch

Description: The Behavioral Finance subgroup of the Health Section will be publishing a series of literature reviews in Health Watch. This is the first review of three in the series. The reviewed article describes an attempt to place an econometric value on consumers’ preferences between broad and narrow networks.

Description: ASOP No. 6 Exposure Draft Provisions Relating to Community- Rated HMO Contracts. Discusses determination of initial per capita health care rates, effect on valuation results, accounting standards, potential conflicts with FAS 106 and source of problems. Issue No. 42.

Description: When setting reserves, multiple methods are often used in the creation of the reserve estimate. Judgment is warranted to combine these different estimates into a final recommendation. This paper describes two techniques that can be used to combine these estimates that may result in better accuracy and lower variance.

Description: Summary of the health section council’s research project to assess the accuracy of commonly used IBNR estimation methods over a wide range of scenarios.

Description: Medicare Advantage Organizations must consider influences both internal and external to the adjudication process as they review and use data for bid preparation

Description: Clinical Insight Modeling MST and RAI models development of predictive modeling software, utilization of all data, validating models. Issue No. 42.

Description: Calculation of IBNR Reserves compares IBNP lag method to Incurred Claims PMPM method which produces lower Variance. Issue No. 46.