Description: This article will consider several issues arising from ACO budgeting and pricing of stoploss coverage, including: 1) attribution of members; 2) claim carve outs; 3) ambiguous stoploss terms; 4) providers gaming the system and 5) credibility of data.

Description: Comparison of healthcare costs for early retirees versus active workers in the same age band. When adjusted for age, there is not a significant difference in costs between each group.

Description: This article contains a condensed summary and excerpt from the fourth white paper in the Commercial Health Care: What’s Next? series.

Description: This article contains a condensed summary and excerpts from a recent white paper regarding the Individual Mandate.

Description: Discussion of direct primary care and how it helps with several challenges in health care today. DPC improves care coordination, improves outcomes, improves doctor and patient satisfaction, and reduces spending. DPC successes promote the view that primary care should not be covered by insurance; rather, it should be paid for directly.

Description: An analysis of the 1999-2011 experience of all Blues plans of betweeen $1.8 and $3.8 billion in annual revenue in 2010 to determine if there is any empirical evidence of an industry underwriting cycle. The analysis shows there is no such evidence.

Description: A brief description of current events and techniques that may impact trend models.

Description: The interview discusses the ACA exchange intiatives program, a strategic project of the SOA focusing on ACA marketplace emerging data and actuarial principles

Description: Hear from the chairperson on themes in the March 2017 issue of Health Watch, published by the Health Section.

Description: An economics professor and a health care consumer advocate weigh in on the Patient Protection and Affordable Care Act, including implementation issues, directions for the future and what role actuaries shoudl take.