Description: This article is focused on sustainability concerns in the ACA individual markets and what we can learn from core actuarial principles as discussed in ASOPs.

Description: The editors preview the articles in the February 2010 issue of Health Watch.

Description: A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay less than the true cost while others must then pay more, to a 'value for money' system. This would be achieved by requiring providers to bill all patients the same rate for the same services, with a standard bundling format to make all providers' rate differences transparent. Differences between billed charges and what Medicare pays would be made up by the Medicare patient, rather than subsidized by those outside of Medicare.

Description: This article provides an overview of the Own Risk and Solvency Assessment (ORSA) model act, and of enterprise risk management (ERM). Compared to other actuarial disciplines, health actuaries have not historically focused as much on ERM. But health coverages do have risks that can threaten an insurer's solvency, and ORSA (now in force in most states) will force health insurers to beef up their ERM capabilities.

Description: A look back at the 30 years since the Health Section was formed.

Description: A rethinking of current provider reimbursement, focusing on incentives instead of simply cutting fees. The recommended 2-pronged approach would feature integrated provider organizations as well as evidence-based decision making organized around episodes of care.

Description: Health Section Chair, Jennifer Gillespie, discussed the Health Section and other organizational resources, in the context of a list of recommended career resolutions for actuaries.

Description: A summary of the driving forces behind, and effects of, the historical increases and future expectations of Generic Dispensing Rates.

Description: Article compares HMOs to other one stop non-health corporations that have gone away and states still in existance only due to forced government regulation, Issue No. 39.

Description: Changes in CMS requirements for 2011 Medicare Part D plans aimed at reducing confusion surrounding the PDP selection process by making plan differences more visible to seniors. Carriers have responded by making the most significant changes in plan offerings since the program's inception, which is expected to result in membership shifts.