Description: Presenter discusses issues related to alternative care, as well as SOA activity in regard to alternative care. From the Record of the Society of Actuaries, Vol. 24, No. 1.

Description: This session discussion is about two proposals for health-care reform will be presented, one from the Blue Cross/Blue Shield Association and one from the Council for Affordable Health Care. These dramatically different proposals will be compared and open for critique. From Record of Society of Actuaries Vol. 18, No. 4A.

Description: Article from the Pension Section News, June 2000, on the simple logic of health care inflation. This article is reprinted with permission and ran in the April 2000 issue of Health Section News.

Description: Accurate forecasts of future health care expenditures for cohorts of elderly individuals can be especially difficult. Current techniques use average per capita costs, based on local experience, adjusted for the cohort's age, sex, institutionalization, and welfare status distribution. This paper presents a method to adjust such per capita cost estimates to reflect more accurately the likely health status of a particular cohort. The adjustment uses the cause-of-mortality profile in the local population, which is a readily available tabulation known to be highly correlated with a major proportion of total medical care expenditures for people beyond age 65. From Transactions of Society of Actuaries 1984, Vol. 36.

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: 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: This session covers the economic principles of “buffet pricing” and whether such pricing can be used for health care. Presented is an argument in favor of “all you can eat” pricing of health care where consumers pay a fixed fee and have no constraints on consumption. From the Record of the Society of Actuaries, Volume 27, No. 1, Session 118

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: Why health care inflation exceeds the Consumer Price Index CPI due to tax implications. Issue No. 37.

Description: Essay stating accessibility, affordability and efficiency are the key to success in the future of healthcare.