Description: This article contains excerpts from the first three articles that were released through the strategic initiative - Commercial Health Care: What’s Next?

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: Mental health spending has reached $147 billion in the United States with demand only increasing greatly impacting society as nearly 1 in 5 experience these issues. There are even more indirect costs associated with mental health causing a national crisis surpassing 1 percent of the GDP. These costs coupled with the severe lack of licensed clinicians calls for an innovative solution. Through years of development and completion of a randomized controlled trial, Prevail has built and validated a low-cost, scalable solution. Prevail's clinically proven digital mental health treatment provides increased access to care while reducing overall health costs. Private and public payors should being reimbursing this model and offering it to their members.

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: Recap of content contained in the May 2013 issue of the Health Watch newsletter.

Description: This article discusses new opportunities for states to waive certain marketplace requirements of the Patient Protection and Affordable Care Act. The article focuses on specific opportunities for states and the role that actuaries will play.

Description: A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay less than the true cost while others must then pay more, to a 'value for money' system. This would be achieved by requiring providers to bill all patients the same rate for the same services, with a standard bundling format to make all providers' rate differences transparent. Differences between billed charges and what Medicare pays would be made up by the Medicare patient, rather than subsidized by those outside of Medicare.

Description: The healthcare industry is in the middle of extraordinary times. This article outlines the many forces driving this transformation, as well as various obstacles. This has both personal and business implications to health actuaries.

Description: The editors of Health Watch have made health care reform the focus of the Sepctember 2009 issue, and provide an introduction to the issue's contents.

Description: Recap of content contained in the January 2014 issue of the Health Watch newsletter.