Description: Presented at October 1986 Annual Meeting. Discussion covers: how hospitals and hospital management companies are increasingly entering traditional indemnity insurance markets, hospital representatives address health care financing from the hospital perspective, the risks and financial incentives from the hospital's perspective, and whether hospitals are marginally pricing their health insurance products.

Description: Taxes and Fees Introduced by the ACA

Description: A compilation of feedback from actuaries in the Health Section of the affects of the ACA.

Description: This 1991 open forum discussion is about the resource-based relative value scale [RBRVS] and its impact on physician fee trends [Medicare and non-Medicare], physician specialization, utilization, Medicare supplement plans, employer plans [active and retired], HMOs, and physicians and senior citizens. From the Record of the Society of Actuaries Vol. 17, No. 3A.

Description: This article describes the results of three years of work by Blue Shield of California to collaborate with hospitals and physician organizations to reduce cost and improve quality for commercial populations in targeted geographies.

Description: Presented at April 1985 Spring Meeting. Addresses questions being asked about the future of health care financing: 1. Will the traditional insurer-based program be the predominant financing mechanism in the future? 2. Will Preferred Provider Organizations, Health Maintenance Organizations or other mechanisms displace current approaches? What additional institutions will enter this field? 3. What major factors will determine the outcome?

Description: Presented at June 1986 Spring Meeting. This session discussion is about the status of state and federal regulations regarding the development of PPOs and other alternate delivery systems and anti-trust laws affecting PPO development.

Description: Presented at October 1986 Annual Meeting. This session discussion is about joint ventures between Health Maintenance Organizations 'HMOs' and insurance companies, dual or triple option rating strategies, how these ventures are structured from a financial standpoint, and how separate organizational objectives are met.

Description: Summary of testimony by an AAA Board member before a congressional subcommittee, as an expert on risk assessment and adjustment, especially in relation to Medicare risk contracting and HMO payments. She recommended: mitigating the geographical region values, credibility weights for payments to health plans, carving out high cost claim segments, reengineering the ACR methodology, shifting AAPCC methodology from fee-for-service toward competitive bidding, and further projects to improve risk methods.

Description: Review of reimbursement methodologies APGs, APCs, Medicare ASC, discount on charges, commercial hybrid, methods and trends in contracting, impact on trent, benchmarking. Issue No. 44.