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

Description: Paper summarizes articles on quality care issues including - measurement & reporting, financing, patient safety, standards & education, and leadership.

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

Description: This paper provides a description of a method that one can use to develop an estimate of accident year incurred losses if the only available data is aggregate paid losses by calendar year for a number of calendar years. An exhibit demonstrating the use of this method follows this description. From Actuarial Research Clearing House 1993, VOL. 3.

Description: Discussion of new individual life, annuity and disability product developments designed to meet conditions in today's market. This article was presented at the Spring 1975 Meeting in Los Angeles.

Description: This 1978 panel discussion is about personal casualty lines on a group basis. It focused on: 1. The traditional approaches of group life and health versus individual policies for fire and casualty 2. Problems in product design and underwriting, and 3. The impact of federal income tax laws. 4. Regulatory constraints. The discussions were primarily on personal automobile insurance.

Description: This 1978 session looked at the intersection of social and private insurance including: 1. Social insurance involvement in casualty and property coverages 2. Impact of social insurance and individual disability insurance 3. Social insurance impact on private retirement plans in the United States 4. Social insurance impact on private retirement plans and on individual insurance plans in Canada

Description: This 1978 session focused on regulatory considerations in Group Health Insurance focused on the following questions: 1. What is the impact of National Health Insurance and Federal Hospital Cost Control? 2. What is the impact of non-discrimination legislation and regulation? 3. What is the impact of recent OASDI financing changes and changes in mandatory retirement age? 4. What is the future of multi-employer trusts and self-insurance?

Description: This session is about structuring an HMO, rating, financing & solvency and underwriting. From Record of Society of Actuaries 1979 Vol. 5, No. 4.

Description: Learn about key actuarial and analytic tools and methodologies used by commercial health insurance to identify and quantify drivers of healthcare cost and utilization (including wasteful and low-value ones) and risks. Use case scenarios in which these tools and methodologies apply, such as underwriting, reinsurance, medical management for population health and chronic diseases, managed care contracting, insurance market reform, provider payment reform, etc., will also be covered. Experience from the U.S., China and other parts of the world will be shared.