Description: This SOA-funded study examines the relative performance of different risk assessment methods and risk adjustment systems. From A Comparative Analysis of Methods of Health Risk Assessment, M-HB96-1.

Description: Panelists discuss the history of this 75-year-old Medical Information Bureau MIB, its very active and data-rich source of medical information, and the services that the MIB offers to clients and other industry groups. From the Record of the Society of Actuaries, Vol. 24, No. 1.

Description: Panelists use defined-contribution health plan case studies to review successful plan designs, effective plan communication strategies and plan implementation issues. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 64

Description: Introduction sets out the objectives of comparing the predictive accuracy of different risk assessment methods, comparing the different methods based on other criteria, and then examining issues related to high-cost individuals and conditions. From A Comparative Analysis of Methods of Health Risk Assessment, M-HB96-1.

Description: This paper applies the principles and methodologies discussed in earlier papers in this series to measure cost savings from a two-year disease management DM program for the 200,000 Medicare members of a regional managed care plan. We then study how savings estimates change when we allow for four variations in key assumptions: methods for identifying or excluding plan members, requirements for eligibility in the health plan, methods for calculating health care trend and study design. Finally, we also examine the sensitivity of these results to product type by comparing the Medicare results to those of the Commercial HMO/POS product. Paper 8 of an 8 paper series titled: “Evaluating the Results of Care Management Interventions: Comparative Analysis of Different Outcomes Measures” sponsored by the Society of Actuaries’ Health Section and the Committee on Knowledge Extension Research.

Description: Presented at June 2002 Spring Meeting. Discusses the types of combination products currently on the market, as well as the challenges and opportunities involved in designing new types of combination products.

Description: This session discusses various techniques for evaluating the success of an existing network as defined by profitability, risk exposure and long-term viability. Topics include network design, provider changes and quality measurement. From the Record of the Society of Actuaries, Volume 28, No. 2, Session 92

Description: Synopsis of the report of the SOA Medical Effectiveness Task Force, which discusses the concept of health plan performance measurement and the contribution actuaries can make to this.

Description: This session discussion is about pros and cons of the NAIC recommended rate filing guidelines, pros and cons of renewal rating practices of MET and individual major medical business. From Record of Society of Actuaries Vol. 16, No. 1.

Description: This article compares three potential approaches to determining new coefficients for health-based risk scoring models: full recalibration, p-value credibility weighting, and penalized ridge regression.