Description: During the past few years, performance, cost, and risk trends for Medigap products have undergone substantial changes. Some of these trends could ease cost pressures on Medigap insurers, while others might increase them. Part 1 of this Issue Brief article discusses current changing trends and considerations around about how they are impacting Medigap.

Description: Derek Ray shares his excitement on serving as Chair of the Health Section Council in 2024, including recent section achievements, upcoming activities and a call to action for volunteers to contribute their expertise to the SOA.

Description: Calculation of IBNR Reserves compares IBNP lag method to Incurred Claims PMPM method which produces lower Variance. Issue No. 46.

Description: This article explores the disruptive applications of blockchain, an emerging technology, and its impact on the pharmacy benefit space, and pharmacy benefit managers (PBM).

Description: Discussion of issues from The Credibility Task Force for Health Coverage. From Health Section News, June 1998, Issue No. 35.

Description: In April 2018, the Centers for Medicare & Medicaid Services (CMS) published a revised definition of primarily health related (PHR) benefits as applicable to Medicare Advantage (MA) organizations.

Description: This article attempts to make a modest contribution to the dialogue on the potential and risks associated with novel treatments such as cell & gene therapies. With a fast-expanding roster of what are believed to be one-time treatments at ever increasing price points aimed at curing a wider swatch of the population, they are as much a source of relief for patients stuck in medical limbo, as they are a source of anxiety for payers.

Description: The article documents the efficacy of infra-low frequency neurofeedback regarding how it improves patient no show rates, decreases mental health symptoms by 40% or more, and self-harm and suicidal ideations.

Description: This corner serves to update the membership of some of the section’s milestones for this year, set the trajectory for 2009, and thank the many dedicated individuals and teams who made it happen. Issue No. 59

Description: The big event of 2023 is the launch of multiple Humira biosimilars, which began in January with the arrival of Amgen’s Amjevita on the market. The launch of Amjevita kicks off the process of changing the specialty drug marketplace in the United States. The expectation of the full impact of this big event is very hopeful, but there is still uncertainty several months after its beginning. Humira is the highest-selling drug in the world and has been since 2013 (Figure 1)—except for when COVID-19 projects temporarily surpassed it. The world is eagerly awaiting the launch of multiple biosimilar drugs to compete with Humira and hopefully bring more competitive pricing to the benefit of payers and patients everywhere.