Description: The medical scheme approach adopted by several African countries has failed to meet the needs of those in informal employment and rural communities. This is partly due to affordability amongst these individuals as well as a lack of awareness of how healthcare financing products work. Community based healthcare organisations have achieved greater levels of success in this regard by carefully incorporating the peculiarities of communities in benefit design and involving community members in the management of these healthcare solutions. There are lessons to be garnered from the countries where these have been implemented with some level of success. Even as countries aim towards universal health coverage, observing the unique needs of different communities within a country is essential to ensure resources are utilised efficiently and that healthcare needs are targeted effectively.

Description: This essay discusses the long overdue effciencies that would improve the quality of healthcare in the United States.

Description: Essay reforming management in health care, structure of reimbursement, program management, health information, measurement systems, etc.

Description: This session is about rationing health care. From Record of Society of Actuaries Vol. 18, No. 4A.

Description: Family members who care for people with dementia need a wide range of support services to help them do the important work of care giving at home.

Description: This article focuses on the capitation rate development methodology for the Medicare-Medicaid Financial Alignment Demonstration. It also describes the background behind the establishment of the initiative and how it will be evaluated.

Description: Highlights of health related articles from the North American Actuarial Journal. A paper on health care reform and efficiency is published in a recent issue of the NAAJ.

Description: Successful healthcare reform: First, it must help that must keep healthy people healthy. Second, it must help people mitigate or eliminate the health-risks associated with unhealthy lifestyle behavior choices, and Third, it must ensure the provision of evidence-based care to those who are ill.

Description: This paper provides an outline of three potential initiatives that may be undertaken by the government and the private sector. The first initiative aims at reducing the cost of health care at the provider level. The second initiative provides a means to improve the quality of health care. The third initiative creates a constructive basis for identifying medical best practices to enhance quality.

Description: This article compares the Prescription Drug Plan (PDP) market to the commercial individual market exchanges included in the Affordable Care Act. PDP carrier actions to date could help predict certain aspects of the exchange market.