Description: On February 15, 2022, the Association Forum Health Care Collaborative, a collection of metropolitan Chicago based Healthcare associations, held its winter event. This virtual gathering featured two sessions titled: “Healthcare Policy Perspective” and “Megatrends and Tipping Points that will Define Success in the "New Normal".

Description: This research report provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud.

Description: The objectives of this paper include an assessment of the basis of volatility of experience and financial results, considering the risks and uncertainties associated with long-term policies, especially LTCi. In so doing, it is observed that a properly determined provision for risk and uncertainty is needed in premiums and reserves. It then describes the approaches that can be taken to quantify such a provision in new and re-rated LTCi. The paper discusses possible mitigation approaches that have and should be taken, especially but not limited to the use of policy design features to enhance the alignment of interests of the LTC insurer and its policyholders. It also explores the relationship between historical and expected future risks and uncertainties specific to LTCi. It concludes by pointing out the pervasiveness of the uncertainties involved, the earlier underestimation of the uncertainties involved, although the actual degree of uncertainty may have decreased over time as relevant experience has been obtained. Effective management of LTCi demands incorporation of mitigation approaches in its product design and continuous monitoring of relevant experience.

Description: This report provides a thorough educational resource that can be used by health actuaries and others to help explain various types of provider payment and risk arrangements.

Description: This is a finalist submission for the 2018 Student Case Study Challenge.

Description: This paper sets forth hospital utilization data from 1978 by age and sex for both prepaid hospital contracts and contracts supplementing medicare. In addition, hospital continuation data from 1977 is provided from regular contracts. From Transactions of Society of Actuaries 1983, Vol. 35.

Description: The report looks at the different outcomes for the 50 states from the ACA, in terms of cost and availability of health insurance coverage. It identifies 11 key observations since the passage of the ACA.

Description: This research report is sponsored by The Society of Actuaries and the Canadian Institute of Actuaries on the Canadian health care system. Performed by Stéphane Levert, FSA, FCIA, the study (available in French and English) estimated the future costs of the Canadian health care system, assessed the sustainability of the system over a 25-year horizon, and analyzed the implications of the changes to the Canada Health Transfer proposed on Dec. 19, 2011 by the federal government. The report summarizing the findings indicates that, without significant government intervention, the Canadian health care system in its current form is not sustainable.

Description: Technical report to accompany Fifty States, Fifty Stories: A Decade of Health Care Reform Under the Affordable Care Act.

Description: The Canadian public health care delivery system continues to experience growing needs for increased funding. The total health care delivery system today costs Canadians $98 billion a year or about 9.7 percent of GDP. Of that total cost, 71 percent is paid by the government, which means the taxpayers. While that may pale in comparison to the costs in the U.S., it does make the Canadian system one of the five most expensive health care delivery systems in the world. While today’s cost pressures are of major concern, of even more concern are the costs being projected by many participants in the current health care debate for the period when the Baby Boom makes higher demands on the Canadian health care delivery system. Traditional projection methods, however, do not differentiate between the elderly who survive the year versus those who die as to their use of health care systems. This paper first looks at the impact that this differentiation could have on projected costs. Second, the paper looks at the impact that the wide use of Advance Directives [also called Living Wills] might have on future health care costs and some of the issues surrounding their use. From Actuarial Research Clearing House 2004, Vol. 1.