Description: This article provides an overview of behavioral economic theory as it relates to health and welfare insurance plans and provides summaries of two sample applications of the theories: enrollment in health insurance exchanges created by the Patient Protection and Affordable Care Act, and product design considerations in light of vast health illiteracy.

Description: This article looks at the Return on Investment for Disease Management and highlights point to consider. From Health Watch Newsletter, May 2006, Issue No. 52.

Description: Discussion and Opinion on how randomness affects measurement of provider contracting risk-sharing agreements

Description: This article discusses the positive aspects of E-prescribing, a transaction in which a physician transmits a prescription directly to a pharmacy through an electronic device. Issue No. 60

Description: Summary of the 1974 report of the HIAA Prevailing Health Care Charges System which contains data from about 900,000 charges for up to 1,600 different surgical procedures, summarized for 250 geographical areas. From The Actuary Vol. 9, No. 7

Description: First dollar carriers, stop loss carriers, and reinsurers play a different role in reimbursing healthcare claims. This article explores the reinsurer's role in reimbursing COVID-19 related claims.

Description: Methods and assumptions used in the valuation of savings by external care vendors

Description: The momentum in value-based care has produced an opportunity for actuaries to become pioneers in health care

Description: This article examines the costs of mental health parity, presents the primary drivers of cost increases from legislation and shows evidence the initial cost projections were too high. From Health Section News, March 2005, Issue No. 49.

Description: In the evolving realm of healthcare actuarial practice, value-based contracts are reshaping the landscape. This article explores the pivotal role of AI-enhanced Electronic Medical Records (EMRs) in empowering actuaries to navigate this dynamic sector. Despite challenges in data standardization, AI-enhanced EMRs offer a solution by extracting and standardizing diverse medical records. The article delineates how AI-EMR integration benefits actuaries and provider organizations, enabling more accurate forecasting, earlier shared savings prepayments, and real-time quality metric aggregation. Moreover, it discusses how this fusion addresses historical data limitations, can help project catastrophic claims, and can help identify risk score capture opportunities. Ultimately, it indicates the transformative potential of AI-EMR synergy, positioning actuaries at the forefront of healthcare analytics with unprecedented precision and insight.