Description: This article describes some of the traditional profit measurement standards for direct marketing and then presents a more comprehensive and up-to-date foundation for insurance direct marketers and actuaries to use when reviewing individual direct marketing campaigns or total marketing programs.

Description: This article is about the relationship of brand advertising to direct marketing and how to bridge the gap.

Description: The purpose of this document is to inform the user of the 2022 Health Care Cost Model about the sources of data, other reports, and assumptions which were used to populate this report and drive some of the key considerations.

Description: The purpose of this document is to inform the user of the 2021 Health Care Cost Model about the sources of data, other reports, and assumptions which were used to populate this report and drive some of the key considerations.

Description: Representatives of various health care professions will address issues such as falling hospital occupancy rates and a growing shortage of primary care physicians. The presenters will then discuss the short-term and long-term effects of these issues on the health care delivery systems on North America. From the Record of the Society of Actuaries, Vol. 21, No. 3b.

Description: Risk Adjustment continues to be a hot topic in Health Insurance since its emergence. This mechanism came into being as a means of reducing the risk of selection, particularly in marketplaces where underwriting is not allowed, and rating factors are significantly restricted. Risk adjustment serves to adjust premiums to reflect the risk of individual members or overall members as a whole within a particular cohort of a health plan. Risk adjustment is not perfect, as it does not perfectly predict future costs or perfectly adjust for the differences in expected costs. Different marketplaces have different challenges with risk adjustment.

Description: Learn more about the reasons for provider consolidations and shortages as well as their impact on health care morbidity.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: This session will explore the various contracting techniques that CMS, providers, and employers are using to achieve their strategic objectives across both the Commercial and Medicare markets.

Description: This report illustrates employer group commercial health care costs and trends from 2013 – 2017.