Description: This abstract describes a paper that describes two predictive models for hospital readmission rates using patient level data with specific patient information.

Description: Working in a silo can mean a greater risk of accidental injury or death, but it can also imperil your actuarial career.

Description: This article summarizes what is new with the Academy health practice council. Issue No. 59

Description: The article offers a discussion about future products, distribution, insurance laws, and contracts. Some ideas might not be possible today, but it is offered as food for thought.

Description: Any prudent organization that is obligated to cover health claims will consider the risk that those medical claims vastly exceed expectations. This is true for an employer self-funding employee health benefits, a health system contracted with two-way risk (e.g., Accountable Care Organizations ACOs), and a small or mid-sized health insurance company. Without protection, these risk bearers can incur ruinous losses. Interestingly, the forms of insurance sold to cover such large medical claims, although quite similar, sometimes go by different names depending upon the buyer. • Employer Stop-loss (ESL): self-funded employers who want protection against large unanticipated claims • Provider Excess (PXS): at-risk health systems who have taken delegated risk from a public or private payer and desire protection against large unanticipated claims • Medical Excess/HMO Reinsurance (HMO Re): health insurers (including HMOs) who desire protection against large unanticipated claims The concepts we discuss in this article apply to all three categories of large claim risk.

Description: This article discusses the problems in estimating the prevalence of HIV infection.

Description: What can the United States learn from other countries' health care systems? How are other countries more efficient? We selected five countries that have been among those debated as having some of the most efficient health care systems to explore what the United States can learn from these examples.

Description: What are Biosimilar drugs? Are they the same as generic drugs? What potential impact might Biosimilars have in the United States prescription drug landscape and it’s economics? This article explores those questions as well as exclusivity and interchangeability.

Description: There are growing concerns that the Asian bird flu virus will evolve into a form that can be transmitted from human to human, thus unleashing a new global flu pandemic. This article uses the Spanish flu epidemic and the German life insurance portfolio to analyze the additional claims expenditure due to a pandemic.

Description: This is an introduction to the SOA call for essays around risk strategies pertaining to the diverse risks found in retirement. We are pleased that these essays can be included in this issue of Pension Section News, along with a short interview with each author.