Description: Health insurance company assets and liabilities have evolved since the Patient Protection and Affordable Care Act (ACA) was signed into law in March 2010. The ACA fundamentally rearranged how commercial health insurance is funded by integrating federal premium subsidies and pass-throughs together with a marketplace interwoven with transfer payments among stakeholders. The impacts of these programs can be seen in specific accounting items on the balance sheets of health insurance companies over the past 10 years. Their emergence follows three primary trends: (1) balance sheet items tend to be larger and take longer to settle, (2) there are more interactions among items, and (3) the final settlement amounts are more uncertain.

Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: This article describes Medicare Supplement and short-term care products in more detail, and we compare their risk profiles. We explore the concept that these two products—when offered together—may provide a complementary hedge of certain policyholder behavior risks.

Description: This interview article summarizes the work being done by a Health Section Strategic Initiative Committee.

Description: Review of a research project, co-sponsored by the SOA, which examined 83 organizations and over 150 programs that measure the quality and efficiency of hospitals and physicians.

Description: Why health care inflation exceeds the Consumer Price Index CPI due to tax implications. Issue No. 37.

Description: How benchmarking actual performance to a published source is a useful tool in assessing the value added by a particular program or MCO, Issue No. 38.

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

Description: Considerations in the applications of Predictive Modeling for health care management. Issue No. 47.

Description: Since health care reform has made accountable care organizations a hot topic, an SOA workgroup is addressing relevant questions, including provider risk under various ACO models, limitations of the Medicare model for motivating change in the health care delivery system, strategic priorities, attribution of members, meaurement, and the roles actuaries can play.