Description: The actuarial committee that authored this report developed a model to estimate the revenue the tax would generate. The results point out key considerations for an excise tax on high cost health plans, including the wide range of results generated by sensitivity to certain assumptions.

Description: It is the purpose of this paper to provide data derived from actual claim experience on lives age 65 and over in a form that will facilitate actuarial calculations involving modification of durations of hospital stay and variations in the allowances provided for miscellaneous services billed by the hospital. From Transactions of Society of Actuaries 1963, Vol. 15, pt. 1, No. 43.

Description: Health care is a complex market with a wide variety of stakeholders. These stakeholders have diverse business needs, requiring complicated data-driven decisions. The analytics and research supporting these decisions are often dependent on the availability of real-world data (RWD), which includes a wide variety of data capture technology and data reflecting treatment, clinical outcomes, and costs of health care in real treatment settings (e.g.,, outside of controlled clinical trials). The goal of this panel discussion is to explore how existing and emerging sources of RWD can enhance benefit design, improve risk assessment, influence treatment decisions, and advance the measurement of clinical, humanistic, and financial outcomes. The diverse speaker panel includes actuarial and non-actuarial perspectives, representing the pharmaceutical industry, a health-care services business, and academia. The panel will describe the decision-making that drives their individual needs to use RWD, identify current and developing RWD sources, provide examples of analyses using RWD, and discuss how emerging RWD may influence actuarial analytics and potentiate the development of new interdisciplinary methods and value drivers.

Description: A discussion of the Brazilian Health Industry

Description: The presenters will discuss the range of draft repeal/repair/replace legislation proposed to date, the elements most likely to be included in the final law, and possible temporary and transitional measures to be taken. They will share their findings regarding the impact on the industry of these changes using the most up to date data and modeling available.

Description: Essay stating accessibility, affordability and efficiency are the key to success in the future of healthcare.

Description: A discussion of the future of the Brazilian Health Market with a focus on the legislation which passed in June 1998 to regulate the private health insurance industry

Description: This article makes organizations entering the MA market aware of the star rating climate, as well as short- and long-term star rating & revenue considerations.

Description: Risk adjustment is used to adjust the revenue stream to health insurers that sell ACA eligible plans and Medicare Advantage plans. This article compares and contrasts these risk adjustment programs.

Description: A new statistical approach is presented for calculation of Incurred But Not yet Paid, IBNP, claim amounts. It is based on two new variant methods, the Simple Projected Paid Lag method and the Regressed Projected Paid Lag method.