Description: Through the sponsorship of the Robert Wood Johnson Foundation, The Society of Actuaries partnered with Wakely to use their health care data to study the effects of COVID-19 on overall health care claims for individuals with a COVID-19 diagnosis. The conclusion of the study is that individuals with COVID-19 claims had significant increases in health care costs leading up to their months of diagnosis, as well as in the months following their diagnosis. These effects were more pronounced for individuals who were hospitalized due to COVID-19 as well as for individuals with prior co-morbidities. Finally, the overall health care costs of these members plateaued at significantly higher levels than their pre-COVID baselines. In fact, all the main membership cohorts experienced claim levels that were at least 20% higher than their pre-COVID starting points.

Description: This research report provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud.

Description: A call for essays issued by the SOA Health and Long Term Care Sections on the visions for the future of the U.S. health care system.

Description: The SOA’s research objective is to provide guidance to state exchange officials and administrators, federal officials and administrators, and actuaries assisting states and health plans. The goal of the project is to estimate the morbidity and/or cost for newly insured individuals in the individual market (and to some degree, the small group exchange) relative to the morbidity and/or cost for the current commercially insured population. This analysis will primarily focus on the individual, non-group market. In order to plan for the impact that these currently uninsured individuals will have on the health insurance markets, it will be important to understand their costs relative to the costs for people already enrolled, for whom many health insurers have experience and data.

Description: Kevin Pierce, FSA MAAA divesinto the Inflation Reduction Act’s impact on US drug pricing. He discusses two key provisions: Inflation rebates, where pharmaceutical manufacturers must pay rebates to the government if drug prices rise faster than inflation, and drug price negotiation by Medicare, set to commence in 2026 for selected drugs. Contributors: Kevin Pierce, FSA, MAAA, Deana Bell, FSA, MAAA Mitchell Momanyi, FSA, MAAA, Jon Forster, ASA, MAAA

Description: SOA 2012 Health Meeting Interview with Chairperson Daniel Bailey

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: 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: A report analyzing the cost of care for deceased cancer patients over the last six months of life.

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