Description: Appendixes for the Evaluating ACO Efficiency: Risk Adjustment within Episodes study. The study aims to answer the question of how much of an episode’s cost and use of specific services can be attributed to the patient’s own health status, as opposed to being driven by other factors such as the care setting, patient preference, and provider practice patterns. In other words, do episode costs vary so widely because of patient characteristics, including health status, or are they related to other, nonclinical factors?

Description: This article shows how COVID-19 affected retirement risks, and how retirement planning was impacted by COVID-19. It ties together COVID-19 and its economic consequences with results of two recent consumer surveys that examine retirement risk perceptions and financial well being and a more complete discussion of retirement risks. The Managing Post-Retirement Risks guide divided retirement risks into economic risks, risks and personal planning considerations, and unexpected and unpredictable events. Each of the risks discussed in the guide is discussed in the article with commentary on COVID-19 and its impact, and information about how to manage the risk. For each risk, there is information provided about any insights gained in the two surveys. Results of the two surveys linked to COVID-19 are also discussed.

Description: Changes introduced by various Medicare Alternative Payment Models and the Medicare Access and CHIP Reauthorization Act (MACRA) have accelerated an existing market trend of shifting some of what has traditionally been considered “insurance risk” to providers. The Provider Risk Sharing Boot Camp will give attendees deeper insights into methods, current thinking, and alternative solutions that actuaries can use to help providers understand and manage the financial and actuarial risks that they are taking, many for the first time.

Description: Article from The Actuary, April 1972 – volume 6 - Issue 4 is a review of a book by Lewis C. Robbins, M.D., M.P.H. and Jack H. Hall, A.B., M.D., titled How To Practice Prospective Medicine by assessing and classifying various health risk factors. The review states the authors' basic assumption that average risk can be determined by calculating the total numbers of deaths by cause in the general population is open to criticism. Furthermore, the assignment of weights for the individual risk factors is quite tenuous in many instances. The authors acknowledge this, but once a number appears in print, especially as part of a complex table, it achieves a sanctity that is difficult to destroy.

Description: On March 6, 2023, The Wall Street Journal hosted its Health Forum, a hybrid all-day event. The virtual meeting featured 11 different events. This white paper focuses on those events. The sessions were informative and fast-paced, with each one providing a quick hit of relevant and cutting-edge information around health care.

Description: Fifty-three percent of Americans responding to a survey conducted by the Society of Actuaries (SOA) Research Institute reported that extreme weather events – including hurricanes, tornadoes, heatwaves, wildfires and flooding – have adversely affected their health.

Description: This article on IPV focuses on IPV during the COVID-19 pandemic

Description: Article from The Actuary, October 1971 – volume 5 - Issue 8 that talks about society's love of dirt and how it affects the life insurance industry.

Description: The proposed session will introduce Outcome Based Risk Sharing Arrangements (“OBRSA”) between health insurance payers (“payers”, including insurance companies, health plans, sponsored employers, and government programs) and pharmaceutical manufacturers (“pharma”), and it’s intended to meet the needs of actuaries who focus on pharmacy benefits and risk sharing arrangements. The covered content will include (1) the background of OBRSAs, definitions, stakeholders, and OBRSA’s role in shifting the system from volume-based toward value-based; (2) conflicting perspectives about OBRSAs between payers and pharma (cultural and methodological); (3) identification of incentive gaps between payers and pharma, and incentive alignment between them; (4) barriers to implement OBRSAs; (5) limitations and considerations of OBRSA implementation; and (5) hypothetic OBRSA examples.

Description: This article is about environmental risk occupations, local environment and substance abuse and how they influence actuarial financial estimates. From The Actuary Vol. 24, No. 1