Description: The article describes the insurance industry's preparation for pandemic events and the public finance response.

Description: Introduction to the ACA @ 5 publication

Description: This study aims to answer the question of how much of an episode’s cost and use of specific services can be attributed to the patient’s own health status, as opposed to being driven by other factors such as the care setting, patient preference, and provider practice patterns. In other words, do episode costs vary so widely because of patient characteristics, including health status, or are they related to other, nonclinical factors?

Description: The article reviews high-deductible health plans and poor reimbursement for mental health providers as being the root of 3 devastating problems facing the US.

Description: Appendixes for the Evaluating ACO Efficiency: Risk Adjustment within Episodes study. The study aims to answer the question of how much of an episode’s cost and use of specific services can be attributed to the patient’s own health status, as opposed to being driven by other factors such as the care setting, patient preference, and provider practice patterns. In other words, do episode costs vary so widely because of patient characteristics, including health status, or are they related to other, nonclinical factors?

Description: In this video Scott Allen, FSA, MAAA discusses the Medicare Advantage Part C bid template. The template helps Medicare Advantage plans estimate costs and premiums, comparing their bids to CMS benchmarks. It’s a complex process involving worksheets that project costs, calculate revenue requirements, and determine rebates, ultimately influencing the plan’s benefits, premiums, and competitiveness in the market. Contributors: Scott Allen, FSA, MAAA, Eric Milner, ASA, MAAA, Danica Turner, FSA, MAAA, Jon Forster ASA, MAAA

Description: Kevin Pierce, FSA MAAA divesinto the Inflation Reduction Act’s impact on US drug pricing. He discusses two key provisions: Inflation rebates, where pharmaceutical manufacturers must pay rebates to the government if drug prices rise faster than inflation, and drug price negotiation by Medicare, set to commence in 2026 for selected drugs. Contributors: Kevin Pierce, FSA, MAAA, Deana Bell, FSA, MAAA Mitchell Momanyi, FSA, MAAA, Jon Forster, ASA, MAAA

Description: In this video led by Mitchell Momanyi, FSA, MAAA, the types of Medicare products available is discussed. This two major types are traditional Medicare and Medicare Advantage. It discusses how traditional Medicare encompasses Parts A and B, covering various inpatient and outpatient services but not long-term care or prescription drugs, which fall under Part D. The video details deductibles, cost-sharing structures, and options like Medigap plans that assist with Traditional Medicare’s out-of-pocket expenses. Mitchell emphasizes clarity and understanding while sharing his expertise in this comprehensive overview.

Description: CLASS Act and ACA