Description: Recent health care reform activity has highlighted the importance of Clinical Integration in improving the quality, safety, efficiency and reimbursement infrastructure of the health care system. This article discusses relevance and implication of regulatory measures, implementation and data issues, and provides an end-to-end example.

Description: Panelists discuss employers' perspective of defining strategies to identify best-in-market opportunities. From the Record of the Society of Actuaries, Vol. 24, No. 1.

Description: Presented at October 1985 Annual Meeting. This session discussion is about trends in utilization review 'UR', preadmission certification, concurrent review, discharge planning, retrospective review, considerations in the design or purchase of UR services, normative data and monitoring UR, recent experience of UR programs and future expectations.

Description: Advisers and Consumers have a difficult task in choosing appropriate inflation protection - this article address the challenges and provides suggestions.

Description: This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection in Medicare.

Description: We highlight a new approach leveraging predictive analytics to identify high risk and rising risk opioid users for more effective screening and follow-up care.

Description: Presented at October 1986 Annual Meeting. This session discussion is about the state-of-the-art in packaged software, the requirements of such systems, and current and future health care developments that must be addressed.

Description: This issue wraps up the publication of essays to explore solutions available to address risks in retirement and focus on risks in a DC environment.

Description: The article focuses on some of the major challenges and considerations an insurance carrier faces with pricing, management, and administration of LTC Combo Products.

Description: This article discusses the advantages, logistical concerns, and pricing formulas of implementing a TNHP, in which members pay less for treatment from providers who meet higher quality and cost-effectiveness standards.