Description: The author takes exception to criticism from the AMA about hospital discharge guidelines as being set by actuaries when, in fact, they are set by physicians based on actual practice.

Description: Article discusses causes of high charges in relations to reimbursement arrangements and possible actions of insurers & payers. Issue No. 45.

Description: This article explores the disruptive applications of blockchain, an emerging technology, and its impact on the pharmacy benefit space, and pharmacy benefit managers (PBM).

Description: Can Direct-to-Provider Contracting Achieve Value-Based Care for Employer-Sponsored Plans? Direct-to-provider contracting is a strategy in which a self-insured entity negotiates a contract directly with a provider of healthcare services rather than through a third-party administrator (TPA), often with the goal of driving value-based care. This article discusses the considerations for employers and providers with direct-to-provider contracting.

Description: This web page contains links to the following articles of interest to actuaries: 1. A July 9, 2011 New York Times editorial about recent studies suggesting that antidepressants aren’t effective after all, and 2. A March 10, 2011 Time Magazine article by Joel Stein titled, 'Data Mining: How Companies Now Know Everything About You.'

Description: This article provides an overview of critical illness insurance: history, product description, and the three primary ways to offer critical illness coverage in the United States. This article also contains an illustration of an issue age premium rate calculation, as well as product features and rating applications specific to the various types of critical illness coverage.

Description: This article discusses the growing number of cases of dementia and its effects on economics and loved ones.

Description: This article discusses fringe benefits for the retired from a 1967 meeting of the Canadian Pension Conference.

Description: Joe Wurzburger, Staff Fellow at the SOA, shares his views and insights about the health care industry in general and the Health Section's role in particular.

Description: Discover the key components of value-based care (VBC) contracts and their impact on provider credibility. Learn about benchmarks, measurement period results, and the unique challenges providers face in managing insurance risk. Gain insights into reducing costs and aligning financial incentives in the US healthcare market.