Description: The ACA’s Medical Loss Ratio Provisions

Description: Introduction to the ACA @ 5 publication

Description: In the article in The Actuary, April 1972 the writer referred to the 15-year study of aging by Professor Edman Palmore of the Center for the Study of Aging and Human Development of Duke University. His research indicated that work satisfaction was the best overall predictor of longevity and the second was overall happiness, reflecting a person's general satisfaction with his or her situation. The author discusses Work in America a paper written during the Nixon administration.

Description: The MACRA/QPP Provider Revenue Model is designed to provide an estimate of the revenue impact of the QPP (MIPS, AAPM) on a provider group or ACO, based on the required inputs and scenarios.

Description: The MACRA/QPP Payer Revenue Model is designed to provide Health Plans an estimate of the expected claim cost increase/decrease due to MACRA.

Description: This paper introduces a single measure combining cost and quality of healthcare. This is used to demonstrate the magnitude of the challenge of the increasing dependency rate. It is then used in assessing a number of alternative financing models, including user fees and alternative compensation methods for physicians. The paper documents implementation issues and evaluates the desirability of implementing these approaches in Canada.

Description: While there are many approaches currently being taken to transform health care, to be successful, we know that leading and planning for quality improvement is a science. Data is the common denominator as healthcare organizations establish best-practices, and ultimately overcome unintended variation through strong analytic systems. Health care leaders require specialized data analysis education and training to hone their skills in understanding and managing clinical variation. The problem with unexplained variation in healthcare is that it negatively impacts clinical outcomes, increases the cost of care, and diminishes value for patients. In this session, Dr. Ted James (BIDMC and Harvard Medical School Faculty) will explain how actuaries can offer practical solutions that provide insights into variations in clinical practice that cannot be explained by differences in medical conditions or patient preferences.

Description: This is the inventory part of the report from the research project that reviewed and inventoried the range of quality and efficiency measures currently available for healthcare. The goal was to outline key areas of quality and efficiency measurement and identify future opportunities for actuaries. The inventory lists the resources and provides brief descriptions of their services with links.

Description: CLASS Act and ACA

Description: Report on the activities of the Academy’s health practice council and its work groups.