Description: Feature article discussing the high cost of prescription medicines in Canada.

Description: Coverage of Medicaid home and community-based services under the 1915(i) state plan option: Attractive features and important considerations

Description: A listing of publications dealing with health insurance, public pensions and taxes 3 separate abstracts on 3 subjects, not related to each other

Description: This article examines the concept of Actuarial Value, especially as it applies to the Medicare plan of benefits. It discusses the cost-sharing responsibility of Medicare beneficiaries and the means by which they mitigate this risk.

Description: The article described recent major advances in measurement of health programs and providers in the public and private sector.

Description: Social Insurance & Public Finance Section council members provide a recap of sessions from the 2021 SOA Health Meeting, with a focus on sessions covering Medicare, Medicaid, the ACA, and public policy. The authors include a description of SIPF Section-sponsored sections, including a session on the ACA and a session on CMS's Direct Contracting Model.

Description: Actuaries have the business acumen, problem-solving capabilities, and technical skills to develop innovative and data-driven solutions in the social insurance space. It is time we expand our scope and embrace an increased role in making a positive impact within the health care ecosystem. The primary focus of this paper is on social insurance programs dedicated to the most vulnerable population: low-income families accessing care through Medicaid. While there are numerous challenges that require other subject matter experts to take the lead, this article highlights topics where actuaries can be key players in developing and implementing tangible solutions to improve the care for the most vulnerable. Issues and solutions in this paper focus on the following three areas: 1. Access to appropriate care, 2. continuity of care, and 3. social determinants of health.

Description: Feature article discussing New York’s answer to publicly-financed health insurance needs.

Description: State Medicaid agencies have been implementing value-based payment (VBP) models for the last decade and are increasingly exploring advanced population-based payment (PBP) models that increase flexibility, predictability, and accountability for participating provider organizations. PBP models show promise in advancing Medicaid priorities, but are still in the early stages of development, and model design and implementation challenges remain. This article from the Center for Health Care Strategies explores the fundamentals of VBP and how PBP - a particular type of payment model - can help Medicaid agencies achieve goals related to care transformation and quality improvement, revenue stability, and controlling cost of care.