Description: While there are many issues in healthcare, the single most significant issue is cost, both in terms of the cost today and in terms of the growth in cost over the past several decades. We need to increase the ability of all citizens to purchase healthcare services or health insurance that in turn purchases healthcare services, and decrease the growth in the cost of healthcare.

Description: Essay reforming healthcare where participants have a vested interest in reaching the best answer.

Description: Risk adjustment is used to adjust the revenue stream to health insurers that sell ACA eligible plans and Medicare Advantage plans. This article compares and contrasts these risk adjustment programs.

Description: Essay discussing cost, quality and access of healthcare and then describes the need for rationing.

Description: Panelists discuss emerging valuation-actuary-related issues, including: [1] for long-term-care insurance [LTCI], reserves, risk-based capital [RBC], and new experience forms, [2] for Medicare Part D, several potential future changes, and [3] for health insurance in general, the new Statement of Standard Accounting Practice 85 [SSAP 85] and existing SSAP 84, and current activities of the International Accounting Standards Board [IASB] regarding a definition of 'insurance.' Session 27PD of the 2005 Valuation Actuary Symposium.

Description: This article compares the Prescription Drug Plan (PDP) market to the commercial individual market exchanges included in the Affordable Care Act. PDP carrier actions to date could help predict certain aspects of the exchange market.

Description: This article makes organizations entering the MA market aware of the star rating climate, as well as short- and long-term star rating & revenue considerations.

Description: The American Academy of Actuaries is engaged in several projects that proactively examine the future status of the Medicare Program. This session presents the findings that have resulted from these efforts. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: Changes introduced by various Medicare Alternative Payment Models and the Medicare Access and CHIP Reauthorization Act (MACRA) have accelerated an existing market trend of shifting some of what has traditionally been considered “insurance risk” to providers. The Provider Risk Sharing Boot Camp will give attendees deeper insights into methods, current thinking, and alternative solutions that actuaries can use to help providers understand and manage the financial and actuarial risks that they are taking, many for the first time.

Description: This session from the 1983 SOA Vancouver Meeting discusses national health policy issues in the U.S. and the impact of these issues on the private health insurance business. Issues include health insurance for the unemployed, non-paying patients and cost shifting, competition versus regulation and DRG prospective pricing for Medicare.