Description: This article discusses the use of parametric distributions to model health care cost.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: Article presents arguements for actuarial involvement to facilitate use of pharmaceutical research within managed care organizations MCO. Issue No. 44.

Description: Implications of Consumer-Driven Health Care to consumers, employers and providers Issue No. 37.

Description: What can the United States learn from other countries' health care systems? How are other countries more efficient? We selected five countries that have been among those debated as having some of the most efficient health care systems to explore what the United States can learn from these examples.

Description: Methods and assumptions used in the valuation of savings by external care vendors

Description: Discussion of Alternative or Integrative Care - Fundamental themes, market demand, recent activity, developing an alternative care program, pricing benefits Issue No. 34.

Description: Gathering information and assess risks of Managed Care Networks. Looking at cost and service areas. Issue No. 44.

Description: This article contains a condensed summary and excerpts from a recent white paper regarding the Individual Mandate.

Description: This article discusses the positive aspects of E-prescribing, a transaction in which a physician transmits a prescription directly to a pharmacy through an electronic device. Issue No. 60