Description: This session presents information sources used in tracking health technologies, the value of health technology assessments and clinical data typically available. From the Record of the Society of Actuaries, Vol. 31, No. 2, Session 4

Description: This session discussion is about controls on utilization, eligibility control, pricing considerations, benefit design, mail order programs and physician dispensing. From Record of the Society of Actuaries Vol. 15, No. 1.

Description: This session discussion is about high cost claimants in medical benefit plans and how to control costs and anti-selection. From Record of the Society of Actuaries Vol. 15, No. 3B.

Description: This session is about the details of the inception and implementation of the Oregon Health Plan. From Record of Society of Actuaries Vol. 18, No. 1B.

Description: Pilot study made determining a satisfactory form for future experience studies under major medical expense insurance.

Description: This analysis provides an overview of the functional components of the managed care system. It discusses the market forces underlying the United States’ system for health care financing and delivery and suggests how market forces impact the health care industry. The analysis focuses on societal goals for health care delivery and on managed care’s effectiveness in enabling achievement of those goals. The analysis develops and uses an innovative model developed to summarize the complex interplay among the many stakeholders, or participants, in the health care system. The model provides a framework for analysis of the many relationships among stakeholders. The analysis also highlights current issues in managed care, particularly the barriers that impede collaboration among stakeholders.

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

Description: This study used commercial data held by the Health Care Cost Institute (HCCI) and Medicare fee-for-service data to analyze health care cost differences by age and their contribution to overall health care cost change. The commercial data includes claims from 2002 through 2010 and the Medicare data includes claims from 2006 through 2010.

Description: In the course of consulting engagements, actuaries almost always find they need one or more of the following resources: -Healthcare data, which may be at the individual patient level or on a particular population. -Health services research studies which describe, summarize, try to alter, or predict patients’ use of health resources. -Health policy information, which describe public or private actions which affect the access, cost and quality of medical care. This document describes the ever-changing resources and specifies where they may be obtained.