Description: Actuaries are increasingly being called upon to advise management about the value of medical management programs and interventions. This session discusses disease management outcome measurements and the cost vs value issues. From the Record of the Society of Actuaries, Volume 30, No. 1, Session 111

Description: Panelist discuss lifestyle issues and their effects on medical costs, both for managing costs and for making decisions about plan design. Topics include employer responses, lifestyle-based profiling, and obesity. From the Record of the Society of Actuaries, Vol. 31 No. 2, Session 27

Description: This paper applies the principles and methodologies discussed in earlier papers in this series to measure cost savings from a two-year disease management DM program for the 200,000 Medicare members of a regional managed care plan. We then study how savings estimates change when we allow for four variations in key assumptions: methods for identifying or excluding plan members, requirements for eligibility in the health plan, methods for calculating health care trend and study design. Finally, we also examine the sensitivity of these results to product type by comparing the Medicare results to those of the Commercial HMO/POS product. Paper 8 of an 8 paper series titled: “Evaluating the Results of Care Management Interventions: Comparative Analysis of Different Outcomes Measures” sponsored by the Society of Actuaries’ Health Section and the Committee on Knowledge Extension Research.

Description: Panelists discuss the successes and shortcomings of disease management as the latest generation of effective managed care. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: This is the abstract for the paper, Measuring DM Program Outcomes: The Use of Incident and Prevalent Populations by Ying Liu, MS and Michael Cousins, PhD.

Description: Panelists continue their discussion of a research project into actuarial issues and financial measurements related to disease management programs. Outcomes measurement is specifically discussed. From the Record of the Society of Actuaries, Vol. 31, No. 2, Session 41

Description: Duncan's personal reflections on the state of care management evaluation.

Description: This paper presents recent trends in obesity prevalence in significant population segments, including overall effects by age, gender and certain racial and ethnic groups, and discusses the ways in which obesity can influence mortality in each of these segments. It provides a synthesis of reported mortality experience relating to these behaviors by risk factors and diseases that will affect any mortality projection.

Description: This paper presents a different approach to measuring Health Expectancy, especially as it relates to the elderly population. This new actuarial approach is described and numerous examples are given.

Description: Disease management [DM] is a health care intervention targeted to individuals with chronic diseases chronics. To justify the investment by payers in DM, it is important to demonstrate beneficial clinical and financial outcomes. This paper analyzes the health cost trends between the chronic and non-chronic populations. Paper 7 of an 8 paper series on 'An Introduction to Care Management Interventions and Their Implications for Actuaries'.