Description: This study aims to answer the question of how much of an episode’s cost and use of specific services can be attributed to the patient’s own health status, as opposed to being driven by other factors such as the care setting, patient preference, and provider practice patterns. In other words, do episode costs vary so widely because of patient characteristics, including health status, or are they related to other, nonclinical factors?

Description: This report evaluates alternative payment models that potentially could be instituted by healthcare payers and manufacturers.

Description: The purpose of this document is to inform the user of the 2021 Health Care Cost Model about the sources of data, other reports, and assumptions which were used to populate this report and drive some of the key considerations.

Description: Excel file containing extracts of utilization and costs for chiropractic and acupunture - females. From a research project examining the utility of standard eligibility and claims extracts for complementary and alternative medical therapies - CAM analysis.

Description: Excel file containing extracts of utilization and costs for chiropractic and acupunture - females. From a research project examining the utility of standard eligibility and claims extracts for complementary and alternative medical therapies - CAM analysis.

Description: This project shows how to use agent-based models to simulate the behaviors of agents in complex health systems.

Description: Appendixes for the Evaluating ACO Efficiency: Risk Adjustment within Episodes study. The study aims to answer the question of how much of an episode’s cost and use of specific services can be attributed to the patient’s own health status, as opposed to being driven by other factors such as the care setting, patient preference, and provider practice patterns. In other words, do episode costs vary so widely because of patient characteristics, including health status, or are they related to other, nonclinical factors?

Description: The Society of Actuaries Health Benefit Systems Practice Advancement Committee sponsored this review of recent academic literature on the US healthcare system covering quality, access, costs

Description: This report presents the results of a market research study to explore untapped opportunities for actuaries in the health care industry.

Description: This research report provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud.