Description: This article begins with a comparison of the commercial risk adjuster to the exisiting Medicare model, and goes on to discuss why the existing strategies employed by health plans will not work in a risk adjusted environment. The article elaborates on the importance of diagnosis coding, controlling member mix, and care management in order to mitigate risks and gain from newly created opportunities.

Description: Article Health Insurance in The Actuary, June 1979, Volume 13, Number 6

Description: Taxes and Fees Introduced by the ACA

Description: A compilation of feedback from actuaries in the Health Section of the affects of the ACA.

Description: Article compares HMOs to other one stop non-health corporations that have gone away and states still in existance only due to forced government regulation, Issue No. 39.

Description: This article compares the Prescription Drug Plan (PDP) market to the commercial individual market exchanges included in the Affordable Care Act. PDP carrier actions to date could help predict certain aspects of the exchange market.

Description: This article describes the results of three years of work by Blue Shield of California to collaborate with hospitals and physician organizations to reduce cost and improve quality for commercial populations in targeted geographies.

Description: Summary of House of Representatives Tri-Committee Bill – H.R. 3200.

Description: Wrap-up of publication and thank-yous.

Description: Feature article with helpful hints on video conferencing and more!