Description: This study used commercial data held by the Health Care Cost Institute (HCCI) and Medicare fee-for-service data to analyze health care cost differences by age and their contribution to overall health care cost change. The commercial data includes claims from 2002 through 2010 and the Medicare data includes claims from 2006 through 2010.

Description: On March 6, 2023, The Wall Street Journal hosted its Health Forum, a hybrid all-day event. The virtual meeting featured 11 different events. This white paper focuses on those events. The sessions were informative and fast-paced, with each one providing a quick hit of relevant and cutting-edge information around health care.

Description: The SOA’s research objective is to provide guidance to state exchange officials and administrators, federal officials and administrators, and actuaries assisting states and health plans. The goal of the project is to estimate the morbidity and/or cost for newly insured individuals in the individual market (and to some degree, the small group exchange) relative to the morbidity and/or cost for the current commercially insured population. This analysis will primarily focus on the individual, non-group market. In order to plan for the impact that these currently uninsured individuals will have on the health insurance markets, it will be important to understand their costs relative to the costs for people already enrolled, for whom many health insurers have experience and data.

Description: The objective of this project is to summarize the existing literature on end of life issues of interest to actuaries, and to document a broad list of such articles. The end of life issues explored are multi-dimensional and from multiple perspectives. When considering cost implications of end of life care, it is necessary to consider cost in a broad context as it is a measure that cannot solely be defined by dollars. Other dimensions of cost, such as quality of care, family care giving, communication, patient preferences and access to care, should also be explored.

Description: A report analyzing the cost of care for deceased cancer patients over the last six months of life.

Description: The Society of Actuaries Health Benefit Systems Practice Advancement Committee sponsored this review of recent academic literature on the US healthcare system covering quality, access, costs

Description: This research material provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud

Description: This study aims to answer the question of how much of an episode’s cost and use of specific services can be attributed to the patient’s own health status, as opposed to being driven by other factors such as the care setting, patient preference, and provider practice patterns. In other words, do episode costs vary so widely because of patient characteristics, including health status, or are they related to other, nonclinical factors?

Description: This report evaluates alternative payment models that potentially could be instituted by healthcare payers and manufacturers.

Description: Appendixes for the Evaluating ACO Efficiency: Risk Adjustment within Episodes study. The study aims to answer the question of how much of an episode’s cost and use of specific services can be attributed to the patient’s own health status, as opposed to being driven by other factors such as the care setting, patient preference, and provider practice patterns. In other words, do episode costs vary so widely because of patient characteristics, including health status, or are they related to other, nonclinical factors?