Description: Read the February 2018 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

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: Highlights of health related articles from the North American Actuarial Journal. A paper on health care reform and efficiency is published in a recent issue of the NAAJ.

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

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

Description: This article from major US payers describes palliative care as a scaleable means of improving quality and reducing costs during serious and complex illness.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: What is the difference between a Single-Payer and Universal Health Care System, and how could the U.S. implement a system that would reduce the growth of medical costs while increasing quality.

Description: A proposal to reform the health care provider payment system through: a national fee schedule, shifting more reimbursements to primary care providers, better integration of hospital & physician fees, evidence based care, pay for performance, and a better provider risk sharing mechanism.