Description: Essential Health Benefits and Actuarial Value

Description: This study was sponsored by the Society of Actuaries Health Section. This paper explores the relative significance of aging as a determinant of financial cost of health care beyond age 50, with particular attention to the effect for ages 65 and older. The paper presents concepts of aging factors and aging curves, which define relative values between ages for utilization or cost of health care services. General conclusions are drawn from Medicare data that utilization and cost differ by age, but that aging factors vary across services and may be less significant at very old ages. The author then turns to the question of measuring the significance of an aging curve assumption and what accuracy is lost in the simpler alternative of a single value across an age range.

Description: Affordable Care Act and Payment Reform

Description: Projecting start-up capital requirements for Health care co-ops and public plans

Description: In this article, we will describe EY’s five-pillar approach that balances practicality with comprehensiveness, and how this applies to LTC model validation.

Description: This article provides a detailed description of the unbalanced subsidy provisions in the Affordable Care Act with easy to follow numerical illustrations. An understanding of the illustrative calculations is necessary to understand the subsidy implications. The article highlights some surprising and likely unintended results that will be interest to issuers, employers, consumers, regulators and policymakers. Actuaries can add expertise to their clients and to the public discussion with a proper understanding of the subsidy calculations and the resulting implications.

Description: Discussion of some of the debated aspects of the new health care law from an actuarial principles perspective.

Description: This article deeply examines Pay-for-performance and presents curious findings through the lens of unwarranted variation. From Heath Watch Newsletter, May 2006, Issue No. 52.

Description: Disease Management and the impact of overlap, co-morbidity on determining cost savings and employer buy-in. Issue No. 37.

Description: A Regulatory Perspective on Rate Review Before and After the Affordable Care Act