Description: The purpose of the SOA project Modeling Long Term Healthcare Cost Trends for Valuation is to provide a benchmark projection of medical cost increases and provide a user-firendly model for making alternative projections. This paper presents sample output from the model, technical documentation of the model, FAQs, and a review of the literature and references.

Description: To provide a quantitative model to identify potential business disruptors and quantify their impacts.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: ACA risk adjustment is intended to "bridge the gap" between allowed rates and actuarial rates. If risk adjustment methodology is not bridging that gap & becomes an additional input to pricing formulae, it is not serving its intended purpose.

Description: Article discussing the use of enterprise risk management in the health care industry.

Description: This article is intended to inform readers about the current state of mental health and health care in the US, as were it's heading moving forward.

Description: Examines the question of whether health-care costs, or health insurance costs, are in crisis.

Description: Hear from Kevin Pierce, FSA MAAA on the key components on the Inflation Reduction Act as it relates to Medicare Part D. Kevin is a Senior Consulting Actuary at Milliman and a top industry speaker on this subject. Kevin has extensive industry experience in actuarial, finance, and strategic projects, providing market intelligence and strategy support for clients across the health care industry. He outlines key provisions of the act, such as a complete redesign of the benefit, inflation rebate payments from pharmaceutical manufacturers,, and Medicare’s ability to negotiate drug prices. Kevin touches on the changes in costs and complexities for beneficiaries, pharmaceutical manufacturers, the federal government, and health insurers. Contributors: Kevin Pierce, FSA MAAA, Mitchell Momanyi, FSA, MAAA, Deana Bell, FSA, MAAA, Jon Forster, ASA, MAAA

Description: The SOA provides information about the actuarial career path in health care and predictive analytics. Throughout 2016, we will share more about actuaries who are tackling some of the industry's biggest challenges and hear from top employers in healthcare analytics.

Description: This session discussion is about who is the health care manager, how is health care management evaluated, ethical considerations, malpractice liability and data systems support. Inlcudes a discussion on gatekeepers, provider contracting, utilization management, benefit design, DRG creep, long-term care, From Record of the Society of Actuaries 1987 Vol. 13, No. 1.