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: This is a discussion about group life and health insurance. From Transactions of Society of Actuaries 1963, Vol. 15 Pt. 2

Description: The impact of Medicare on retiree medical. Issue No. 44.

Description: The aftershocks of the COVID pandemic will pass --- eventually. Government subsidies and spending soared in 2020 to meet the challenges of the pandemic. Health expenditures leapt from 17.6% of GDP to 19.7%, and then dropped to 18.8% in 2021, and will fall again to 18.2% (projected) in 2022, but are expected to return to the long-run trend by 2024 and gradually rise thereafter. However, during the next few years most attention will be paid to dealing with complex aftershocks from the flood of Covid funding in 2020 and 2021, a surge of inflation in 2022, and a looming recession in 2023.

Description: Critical illness insurance is a popular supplemental health insurance product in the U.S. market. This article discusses how carriers have recently sought to add value by expanded the benefits offered in their critical illness products. Specifically, the article discusses the consumer need and development considerations of adding benefits for autism Spectrum Disorder, Mental health disorders, Specified Disease Coverage, and enhance Cancer Coverage to a critical illness contract.

Description: The Society of Actuaries (SOA) published its first COVID-19 research brief on March 10, 2020, followed by regular updates and expansions through June 12, 2020. The comprehensive report included a section of statistics that highlight the pandemic’s impact on economies in the U.S. and Canada. This report shows updates through September 30, 2020, to selected graphs from the Economic and Asset Impact section of the comprehensive report.

Description: COVID has washed over healthcare like a tsunami—things have been tossed in all directions. According to Medicare actuaries, trends have been turned upside down in 2021, but will reverse back in 2023 as medical costs rebound. It is more prudent to base projections on long run trends for a period after the storm, extrapolating from 2026 forward, leaving the intervening turbulence (years 2022 -2025) mostly unspecified.

Description: In this report, we explore the impact of clustering using the Medical Expenditure Panel Study (MEPS) data for children (aged 5 to 17) to build a bridge between oral health and overall health using dental and medical expenditures. We include social determinants of health as cluster input variables using the Partitioning around Medoids (PAM) method to identify children and their families who could potentially benefit from population health management related to oral health.

Description: Chronic Kidney Disease (CKD) affects many lives and has a large impact on health systems around the world. To better understand and predict costs for insurance plan members with CKD in the United States, we built a new model of their individual costs. Our model is the first to explicitly model both the CKD stage transition process and the distribution of costs given those stages.

Description: The Society of Actuaries (SOA) published its first COVID-19 research brief on March 10, 2020, followed by regular updates and expansions through June 12, 2020. The comprehensive report included a section of statistics that highlight the pandemic’s impact on economies in the U.S. and Canada. This report shows updates through July 29, 2020, to selected graphs from the Economic and Asset Impact section of the comprehensive report.