Description: This SOA report describes the components of margin for calculating capitation rates in a Medicaid context along with practical issues that MCOs may face.

Description: In this session, an employer representative and broker will discuss their views on the current health care marketplace and cost containment including utilization review, self-funded plans and ASOs. From Record of the Society of Actuaries 1987 Vol. 13, No. 1.

Description: In this presentation, Richard D. Lamm, former Governor of Colorado and currently Director of the Center for Public Policy and Contemporary Issues at the University of Denver, talks about the increasing costs of health care and why the miracles of American medicine have simply outpaced our ability to pay. From the Record of the Society of Actuaries Vol. 17, No. 3A.

Description: The panel examines the forces underlying health plans and health carriers profit performance. From the Record of the Society of Actuaries, Volume 27, No. 1, Session 39

Description: This panel discussion presented at the 1980 SOA Spring Meeting in Minneapolis discussed competition in health care delivery from the perspective of what was happening in Minnesota, a key HMO state. From Record of Society of Actuaries, Vol. 6, No. 2.

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: Ian Duncan argues that there is no crisis in American health care.

Description: A report analyzing the cost of care for deceased cancer patients over the last six months of life.

Description: The medical and behavioral health care provider communities have long debated whether high-quality behavioral health care reduces medical costs. This presentation from Session 85PD of the SOA 1996 Colorado Springs Meeting reviews past studies relating to medical cost offsets and explores the potential magnitude of such design and delivery of medical and behavioral health care programs to encourage potential health care cost savings and to increase wellness. From the Record of the Society of Actuaries, Vol. 22, No. 2.

Description: CHCS is a nonprofit policy center focused on improving American health outcomes, particularly for low-income people, including payment & delivery system reform.