Description: Discussion of the impact of the ACA on RBS and required surplus for a health plan

Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: This article reviews the cost of behavioral health care and looks at how the involvement of Primary Care Physicians leads to a less efficient and effective treatment and is an increasing cost many plans have yet to address. From Health Section Newsletter, March 2005, Issue No. 49.

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: An economics professor and a health care consumer advocate weigh in on the Patient Protection and Affordable Care Act, including implementation issues, directions for the future and what role actuaries shoudl take.

Description: An article by the Health Section's Medicaid Subgroup, providing a national perspective on what is happening in the market.

Description: This article discusses the challenges and unknowns relating to the regulatory inclusion of pediatric dental benefits within the essential benefits list of the Affordable Care Act (ACA).

Description: This article discusses new opportunities for states to waive certain marketplace requirements of the Patient Protection and Affordable Care Act. The article focuses on specific opportunities for states and the role that actuaries will play.

Description: This article begins with a comparison of the commercial risk adjuster to the exisiting Medicare model, and goes on to discuss why the existing strategies employed by health plans will not work in a risk adjusted environment. The article elaborates on the importance of diagnosis coding, controlling member mix, and care management in order to mitigate risks and gain from newly created opportunities.

Description: Article summarizes the sessions of the 2011 SOA Health Meeting held in Boston.