Description: This analysis provides an overview of the functional components of the managed care system. It discusses the market forces underlying the United States’ system for health care financing and delivery and suggests how market forces impact the health care industry. The analysis focuses on societal goals for health care delivery and on managed care’s effectiveness in enabling achievement of those goals. The analysis develops and uses an innovative model developed to summarize the complex interplay among the many stakeholders, or participants, in the health care system. The model provides a framework for analysis of the many relationships among stakeholders. The analysis also highlights current issues in managed care, particularly the barriers that impede collaboration among stakeholders.

Description: Summary of pending legislation in response to looming crisis in the Long Term Vare market.

Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: Presenter describes many of the desirable characteristics of a health care financing system, and alternative health care financing systems as they are found in other parts of the world. The advantages and disadvantages of each alternative system are also discussed. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: Why health care inflation exceeds the Consumer Price Index CPI due to tax implications. Issue No. 37.

Description: Drivers of Health Care Affordability. Issue No. 45.

Description: Discussion regarding who's to blame for cost increase, Government's role to ensure coverage and keep costs down, steps to control costs, plan design changes. Issue No. 47.

Description: In this article, the authors explore how the recession has impacted new member enrollment in the various state health care programs and the resulting impact on trend.

Description: In one way or another, COVID-19 has affected everyone’s lives in theUnited Kingdom, with increased evidence of the magnitude of the direct and indirect impacts on health and wellbeing becoming more widely available. Recently, it has been predicted that 10 million people will require new or additional mental health support services in England as a direct result of the pandemic, for the next three to five years.

Description: The healthcare industry is in the middle of extraordinary times. This article outlines the many forces driving this transformation, as well as various obstacles. This has both personal and business implications to health actuaries.