Description: CHCS is a nonprofit policy center focused on improving American health outcomes, particularly for low-income people, including payment & delivery system reform.

Description: This article serves as an introduction to this issue of Health Watch and summarizes the content within.

Description: This article is an interview with Paul Stordahl on his role in the actuarial profession.

Description: The Health Section's strategic initiative entitled Commercial Health Care: What’s Next? focuses on health care reform. This article contains a summary

Description: Because of the expected dramatic rise in chronic disease prevalence due to aging and obesity, and increased cost per case due to new technology and drugs, there has been intense focus on managing the cost of treating chronic diseases. From Financing Chronic Care Monograph, M-HB05-1.

Description: This is the second half of a two-part session regarding FASB Targeted Improvement (LDTI) to U.S. GAAP for long durational insurance contracts. Presenters of the session will discuss operational (e.g., data, systems, models and process, etc.) and financial issues concerning the implementation of the accounting changes. We will also discuss interpretation of the new standards specific to accident and health insurance. Throughout the session, we would like to encourage the audience to share their experiences.

Description: This session discussion is about controls on utilization, eligibility control, pricing considerations, benefit design, mail order programs and physician dispensing. From Record of the Society of Actuaries Vol. 15, No. 1.

Description: This session discussion is about high cost claimants in medical benefit plans and how to control costs and anti-selection. From Record of the Society of Actuaries Vol. 15, No. 3B.

Description: Pilot study made determining a satisfactory form for future experience studies under major medical expense insurance.

Description: Countries developing universal health care via an insurance vehicle face a variety of challenges. Deciding which benefits to include, where to proactively manage health, and how to reimburse network providers are just a sampling of the issues governments concurrently manage. Optimal choices are data-driven responses. For example, high rates of cervical cancer or increasing narcotics prescriptions are trends that can be managed through product changes, modified network payment structures, or even employer based outreach. This kind of information is typically gleaned from established health insurance claims data. However, in emerging health insurance markets, this level of granular claims data is largely missing. It is difficult to manage medical trend when the root causes are unclear. This article explores a pilot medical underwriting project in Jordan.