Description: A Regulatory Perspective on Rate Review Before and After the Affordable Care Act

Description: Panel discusses the effects of reduced payment levels to many Medicare managed care organizations. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: SOA’s recently completed research project related to long term projects of health care cost trends for use in post retirement medical valuations.

Description: SOA’s Pension and Health Sections recently released a new resource model for projecting health care trends through the year 2099.

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.

Description: Health Care Cost Trends 2002 - prescription drug, base and leveraged trend. From Health Section News, January 2002, Issue No. 42.

Description: Article about the future roles in health insurance.

Description: An actuarial model that provides financial incentives to providers to offer patients an approach that can reverse chronic disease and reduce health care costs

Description: ACA risk adjustment is intended to "bridge the gap" between allowed rates and actuarial rates. If risk adjustment methodology is not bridging that gap & becomes an additional input to pricing formulae, it is not serving its intended purpose.

Description: The article looks at potential changes in care provider demographics that could ultimately have an impact on the cost of long term care services.