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: Ian Duncan argues that there is no crisis in American health care.

Description: Considerations in the applications of Predictive Modeling for health care management. Issue No. 47.

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: The editorial shares observations and lessons learned from the process of implementing the Affordable Care Act.

Description: Presenter describes many of the desirable characteristics of a health care financing system, and alternative health care financing systems as they are found in other parts of the world. The advantages and disadvantages of each alternative system are also discussed. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: This article contains a condensed summary and excerpt from the fourth white paper in the Commercial Health Care: What’s Next? series.

Description: Gostin argues that there is indeed a crisis in American health care.

Description: Current Status of managing costs & increasing costs, Future Direction of Consumerism, technology and defined contribution health plans. Issue No. 39.

Description: Article from The Actuary, March 1983, volume no. 17, issue no. 3, that discusses rising health care costs and the challenge it is to actuaries to study the numerous causes and to devise practical means for modifying their effects.