Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: Feature article from the January 2010 issue of In The Public Interest discussing the need for actuarial leadership in the reform of the U.S. health care system.

Description: An article that provides an actuary's opinion of why health insurance reform will work and believes that Congress should use insurance reform as the cornerstone for successful legislation.

Description: This article is about the Balanced Budget Act of 1997. This Act revises the Medicare landscape by the creation of Part C - Medicare+Choice, Medical Savings Accounts, payment reforms.

Description: Two Medicare risk funding provisions that were radically changed by the BBA of 1997 funding variations by geographic area and risk adjustment. Issue No. 36

Description: The chairperson reports on Health Section activities: papers by the joint workgroups with the AAA's Health Practice Council to inform the public and congressional staff, papers on capital requirements under proposed health care reform and on proposed taxing of Cadillac plans, new research on IBNR reserving methods and on measuring the quality and efficiency of health care delivery systems.

Description: Analysis of the projected impact of the Affordable Care Act on Medicare Part C revenue over 2014 through 2017, with background on recent historical revenue trends. The analysis is largely based on CMS published data, with trend analysis based on the Medicare Trustees report and author's assumptions.

Description: This article includes a summary of 2012 Health section activities as well as upcoming events, including the Health '12 Meeting, two HARI research projects (ACOs and risk adjustment), the value of health section membership, and our Canadian Outreach.

Description: This article, an Honorable Mention Essay for the Society of Actuaries' Entrepreneurial Actuaries Section 2010 Papers Competition, is a discussion of the various issues relating to measurement of data in healthcare. The author presents “a light hearted & tongue-in-cheek take on how healthcare is typically measured, and an entrepreneurial vision for a better world.” Noting that typically data is summarized in deterministic models that produce point estimates for analysis and decision making, the author’s vision presented in the paper “is that of a central repository of actuarially modeled distributions that can either be used as benchmarks or adapted to an organization's experience.”

Description: The author reviews the impact of health care exchanges becoming operational in 2014, and he offers ideas for efficient risk identification and ways to measure the results.