Description: Joe Wurzburger, Staff Fellow at the SOA, shares his views and insights about the health care industry in general and the Health Section's role in particular.

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: There has been a proliferation of proposals to expand access to public health insurance plans, either to strengthen insurance markets under the Affordable Care Act (ACA) or to replace the ACA marketplaces or other health insurance programs altogether. These proposals range from creating a public plan that would operate alongside private plans in the ACA marketplaces, to allowing individuals to buy into Medicare or Medicaid, to expanding Medicare to all. The terms used to describe these various options are often used interchangeably but they would be structured differently and have different impacts depending on the implementation details. Panelists at this session will discuss the general approaches for expanding access to public plans and their potential implications.

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: ReMark's Global Consumer Study delivers 10 key insights to empower customers. Insurers can design products that meet customers' needs and enhance client experiences and add significant value to their business. At the same time with new products being launched seemingly continuously, it is important to take a step back and assess risk throughout the product management cycle.

Description: Learn more about interpretable machine learning techniques for health insurance fraud detection.

Description: This panel discussion, which occurred at the October 1982 Society of Actuaries Annual Meeting in Washington D.C., presented information on federal issues that impact health insurance. Topics discussed included: -The Federal Government's role in health care financing - Prospective reimbursement of hospitals - Tax treatment of individuals medical expenses - Primacy of group health insurance for workers over 65 - Budgetary pressure on Medicare/Medicaid - Whatever became of National Health Insurance [NHI]? From Record of Society of Actuaries, Vol. 8, No. 4.

Description: This panel discussion occurred at the SOA's 1980 June Meeting in San Diego and covered Risk Classification. Panelists discussed basic priciples of risk classificiation, and common elements from various systems.From Record of Society of Actuaries, Vol. 6, No. 3.

Description: What is the difference between a Single-Payer and Universal Health Care System, and how could the U.S. implement a system that would reduce the growth of medical costs while increasing quality.

Description: The focus of this article is to provide background to actuaries on the updates in the employer stop loss medical insurance market including underwriting and pricing trends.