Description: Article discussing an alternative method to calculate the PBA deterministic reserve called the “Direct Iteration” method.

Description: A review of literature regarding care management program outcomes - either financial or utilization-related which are indicative of financial improvement or from which financial conclusions may be drawn. Includes a discussion on utilization & concurrent review, case & demand & population & disease management . Paper 3 of an 8 paper series on 'An Introduction to Care Management Interventions and Their Implications for Actuaries'.

Description: A Regulatory Perspective on Rate Review Before and After the Affordable Care Act

Description: Considerable attention has been given in the recent past to the likely economic and social impact of Australia’s ageing population. One particular aspect which continues to be the subject of increased commentary and conjecture, is the need and subsequent costs for Long Term Care LTC. In this paper, a multiple state projection model based on a framework by Rickayzen and Walsh 2002 is constructed in order to project the number of people in Australia who are likely to require LTC.

Description: Research is a primary mission of the Financial Reporting Section and is the largest use of section dues. This scorecard will keep section members informed about research projects sponsored or co-sponsored by the section.

Description: Duncan's personal reflections on the state of care management evaluation.

Description: Panel discusses the effects of reduced payment levels to many Medicare managed care organizations. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: Key findings from a market research study which the SOA undertook as part of their strategic initiative: Untapped Opportunities for Actuaries in Health.

Description: Discussion of the separate and joint effects of obesity and diabetes on disability and mortality, and ways these effects can be used to improved insurance pricing and reserving, reverse the increasing rates of obesity and diabetes, and improve current projections of disability and mortality risks.

Description: This paper describes seven methods used in care management in the order of their historical development: 1. Pre-Authorization 2. Concurrent Review 3. Case Management 4. Demand Management 5. Disease Management 6. Specialty Case Management 7. Population Health Management Paper 1 of a 8 paper series