Description: This paper discusses the insurance plan titled, Connecticut 65 Extended Health Insurance. From Transactions of Society of Actuaries 1961, Vol. 13, No. 37.

Description: Essay where payers desiring to optimize health gains per dollar spent should avoid “across the board” cost sharing, and instead implement a “value based” design that removes barriers/provides incentives to encourage desired behaviors for patients and providers.

Description: This session from the 1995 SOA Vancouver Meeting reviews capitation arrangements in health insurance, the reasons for capitating providers, capitation formulas, cost reduction strategies and the role of the actuary in evaluating experience for capitation. From the Record of the Society of Actuaries, Vol. 21, No. 3a.

Description: In this session at the SOA 1997 Palm Desert Spring Meeting, panelists discuss how managed care dental programs work, the actuarial issues, quality issues, and the perspective of the dentist.

Description: In light of nonprofit health insuring organizations converting from nonprofit to for profit status and with the flurry of health maintenance organization M&A activity, this session at the SOA 1997 Palm Desert Spring Meeting addresses actuarial techniques used to measure 'value' and the issues surrounding such valuation.

Description: Panelists at this session of the SOA 2000 Las Vegas Spring Meeting discuss Medicare Supplement insurance issues, including competitive dynamics with Medicare+Choice and Medicare HMOs, rate increase issues, prescription drug coverage and potential changes to benefit structures.

Description: This session from the 2003 SOA Spring Meeting covers current and future issues relating to individual and small group medical insurance. This includes implications of market consolidation, regulatory issues and demographic trends. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 5PD.

Description: Panelists discuss recent acquisitions and mergers from a variety of perspectives. From the Record of the Society of Actuaries, Vol. 30, No. 3, Session 90

Description: Health care is a complex market with a wide variety of stakeholders. These stakeholders have diverse business needs, requiring complicated data-driven decisions. The analytics and research supporting these decisions are often dependent on the availability of real-world data (RWD), which includes a wide variety of data capture technology and data reflecting treatment, clinical outcomes, and costs of health care in real treatment settings (e.g.,, outside of controlled clinical trials). The goal of this panel discussion is to explore how existing and emerging sources of RWD can enhance benefit design, improve risk assessment, influence treatment decisions, and advance the measurement of clinical, humanistic, and financial outcomes. The diverse speaker panel includes actuarial and non-actuarial perspectives, representing the pharmaceutical industry, a health-care services business, and academia. The panel will describe the decision-making that drives their individual needs to use RWD, identify current and developing RWD sources, provide examples of analyses using RWD, and discuss how emerging RWD may influence actuarial analytics and potentiate the development of new interdisciplinary methods and value drivers.

Description: This article discusses Medical Savings Accounts MSA as proposed in federal legislation and the problems that actuaries will face in predicting their use.