Description: Panelists discuss issues arising from the Health Insurance Portability and Accountability Act of 1996. From the Record of the Society of Actuaries, Vol. 24, No. 1.

Description: Look into history of long-term care insurance industry to understand the forces that shaped current industry's position and to identify new directions.

Description: Presented at October 1986 Annual Meeting. Discussion covers: how hospitals and hospital management companies are increasingly entering traditional indemnity insurance markets, hospital representatives address health care financing from the hospital perspective, the risks and financial incentives from the hospital's perspective, and whether hospitals are marginally pricing their health insurance products.

Description: Panelists provide an update on recent events in consumer-driven health care, including the regulatory environment, results versus expectations and the implications for the overall group health marketplace. From the Record of the Society of Actuaries, Volume 29, No. 3, Session 62

Description: Since health care reform has made accountable care organizations a hot topic, an SOA workgroup is addressing relevant questions, including provider risk under various ACO models, limitations of the Medicare model for motivating change in the health care delivery system, strategic priorities, attribution of members, meaurement, and the roles actuaries can play.

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: This analysis provides an overview of the functional components of the managed care system. It discusses the market forces underlying the United States’ system for health care financing and delivery and suggests how market forces impact the health care industry. The analysis focuses on societal goals for health care delivery and on managed care’s effectiveness in enabling achievement of those goals. The analysis develops and uses an innovative model developed to summarize the complex interplay among the many stakeholders, or participants, in the health care system. The model provides a framework for analysis of the many relationships among stakeholders. The analysis also highlights current issues in managed care, particularly the barriers that impede collaboration among stakeholders.

Description: Panel discussion on how insurers can deal with the proliferation of laws, court decisions and regulations, and on the outlook for future developments in health insurance regulatory environment.

Description: For a long time the primary focus of private LTC insurance companies has been to educate the public about the need for private LTC insurance and to make the product more acceptable to a wider population. To this end there have been numerous changes to the product design to make this product more acceptable to general population. However, one of the things that may have been overlooked in those product design changes is the need for alignment of policyholder and insurance company’s interests, which is to make coverage more affordable and to reduce adverse selection. Incentivizing good behavior from policyholders can not only make LTC insurance policies less expensive but also help policyholders make better health choices, which can help them stay healthy for a longer time. These incentives may also reduce some of the inherent risks in a long term care policy and may help in increasing the sales of private LTC insurance.

Description: This article contains a condensed summary and excerpt from the fourth white paper in the Commercial Health Care: What’s Next? series.