Description: Pricing Small Group Medical Coverage Renewal Pricing regression to the mean, blending of experience and manual rates, small group reform laws. Issue No. 40.

Description: A January 25, 2015 ruling by the US Supreme Court regarding retiree health benefits is the topical springboard for the author to discuss the history and future of retiree health benefits. Topics include actuarial valuation of uncertain benefits using discount rates with risk adjustments derived from equity investment markets.

Description: This article gives an overview of the recent SOA research report on the usefulness of Health Economics and Outcomes Research field in an actuarial context. A description of the structured assessment tool for evaluating new technologies is included.

Description: Adding value in the development, production and marketing process of medical devises regulatory environment, designer/manufacturer perspective, product failure and litigation risk. Issue No. 44.

Description: Introduce basic concepts of the Health Risk-Based Capital and show case a few strategies around Risk-Based Capital.

Description: Discussion of how actuarial input is needed to ensure fair regulations with regards to Genetic Testing. Issue No. 45.

Description: Review of a research project, co-sponsored by the SOA, which examined 83 organizations and over 150 programs that measure the quality and efficiency of hospitals and physicians.

Description: Introduction to population health, a collaborative discipline that seeks to leverage all the determinants of health personal behaviors, medical care and the public health infrastructure, as well as the social and economic context at the community and national level to maximize the health of populations.

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: This article is intended to inform readers about the current state of mental health and health care in the US, as were it's heading moving forward.