Description: Open meeting of the Society's Health Benefit Systems Practice Advancement Committee and Health Section Council, as well as the American Academy of Actuaries' Health Practice Council. The three committees review ongoing projects in the Health Practice area. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: An overview of the issues behind reimbursing providers on a bundled or packaged basis. The article presents the potential advantages offered by the proponents as well as the criticisms and obstacles to implementing this type of payment system.

Description: Summary of pending legislation in response to looming crisis in the Long Term Vare market.

Description: Evaluation of Taiwan's National Health insurance program and a discussion of a managed competition model to reform it.

Description: An economics professor and a health care consumer advocate weigh in on the Patient Protection and Affordable Care Act, including implementation issues, directions for the future and what role actuaries shoudl take.

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: In the course of consulting engagements, actuaries almost always find they need one or more of the following resources: -Healthcare data, which may be at the individual patient level or on a particular population. -Health services research studies which describe, summarize, try to alter, or predict patients’ use of health resources. -Health policy information, which describe public or private actions which affect the access, cost and quality of medical care. This document describes the ever-changing resources and specifies where they may be obtained.

Description: Panel discussion on how insurers can deal with the proliferation of laws, court decisions and regulations, and on the outlook for future developments in health insurance regulatory environment.

Description: A proposal to reform the health care provider payment system through: a national fee schedule, shifting more reimbursements to primary care providers, better integration of hospital & physician fees, evidence based care, pay for performance, and a better provider risk sharing mechanism.

Description: Introduction to population health, a collaborative discipline that seeks to leverage all the determinants of health personal behaviors, medical care and the public health infrastructure, as well as the social and economic context at the community and national level to maximize the health of populations.