Description: This session will discuss the continuing evolution of the managed health care process. Topics include precertification, utilization review, retrospective review, case management, appropriateness review, benchmarking, recredentialing, provider contracting, and integrated medical systems. From Record of Society of Actuaries Vol. 20, No. 3A.

Description: This session discusses continuing care retirement communities. What opportunities exist? What role does the actuary play? From Record of Society of Actuaries, Volume 26, No. 1.

Description: Presented at May 2000 Spring Meeting. This teaching session presents techniques and tools for valuing long-term-care insurance for mergers and acquisitions, drivers behind M&A activity in this market, the appraisal process. Specific situations are discussed.

Description: Panelists discuss current and future developments in health insurance on the Internet and the Health Insurance Portability and Accountability Act from the perspective of providers, insurers, employers and customers. From the Record of the Society of Actuaries, Volume 28, No. 2, Session 131

Description: Panelists provide an overview of the current long-term-care [LTC] market and trends. They cover recent hot topics such as pricing, rate stabilization, administration, marketing, and hybrid/combo products. From the Record of the Society of Actuaries, Vol. 31, No. 2, Session 16

Description: An actuaries' view of what happened to health care reform and the future of reform.

Description: Court cases demonstrating how ERISA Preemption Clause makes it difficult for members to sue Managed Care Organizations MCOs. Issue No. 41.

Description: September issue of Long-Term Care News

Description: Accurate forecasts of future health care expenditures for cohorts of elderly individuals can be especially difficult. Current techniques use average per capita costs, based on local experience, adjusted for the cohort's age, sex, institutionalization, and welfare status distribution. This paper presents a method to adjust such per capita cost estimates to reflect more accurately the likely health status of a particular cohort. The adjustment uses the cause-of-mortality profile in the local population, which is a readily available tabulation known to be highly correlated with a major proportion of total medical care expenditures for people beyond age 65. From Transactions of Society of Actuaries 1984, Vol. 36.

Description: This session discussion is about managed care and various aspects of what is working in managed care. From Record of the Society of Actuaries Vol. 15, No. 3B.