Description: This paper presents some preliminary results of an analysis of data from a regional municipality in Ontario to assess long term care risks. The data includes information on the optimal level of care at one or more points in time for each individual under study modelled using a Markov process.

Description: This report compares health care utilization and expenditures between individuals with Crohn’s disease who had used infliximab and those who had not. Claims data from the 1999-2003 Thomson Reuters MarketScan commercial claims and encounters databases and inpatient, outpatient, and prescription drug claims data of individuals older than 18 years of age with a diagnosis of Crohn’s were included.

Description: This is an Excel spreadsheet showing Appendix C, Primary Tables of the 2008 Valuation Basic Report and Tables. The full report describes the development of the 2008 Valuation Basic Table. It incorporates the Primary Tables, the Relative Risk Tables and the Limited Underwriting tables. Please see the SOA website experience studies for the full report and other related tables.

Description: This fact sheet provides an overview of the Long-Term Care and Middle Market report.

Description: The actuarial committee that authored this report developed a model to estimate the revenue the tax would generate. The results point out key considerations for an excise tax on high cost health plans, including the wide range of results generated by sensitivity to certain assumptions.

Description: This paper proposes the use of stochastic compartment model methods for estimating both the current direct and current indirect costs of specific cancers and for forecasting future direct and indirect costs. From Transactions of Society of Actuaries 1982, Vol. 34.

Description: This paper describes an actuarial methodology [adjusted average per capita cost - AAPCC] developed to meet the requirements of the risk contract that the medicare program makes available to certain health maintenance organizations. From Transactions of Society of Actuaries 1981, Vol. 33.

Description: As carriers have learned over the last two decades, Long-Term Care insurance (LTCi) is a risky business. The intent of this paper is to illustrate how these risks can be better understood through modeling the liabilities using a Monte Carlo simulation approach.

Description: The SOA’s research objective is to provide guidance to state exchange officials and administrators, federal officials and administrators, and actuaries assisting states and health plans. The goal of the project is to estimate the morbidity and/or cost for newly insured individuals in the individual market (and to some degree, the small group exchange) relative to the morbidity and/or cost for the current commercially insured population. This analysis will primarily focus on the individual, non-group market. In order to plan for the impact that these currently uninsured individuals will have on the health insurance markets, it will be important to understand their costs relative to the costs for people already enrolled, for whom many health insurers have experience and data.

Description: A review of literature regarding care management program outcomes - either financial or utilization-related which are indicative of financial improvement or from which financial conclusions may be drawn. Includes a discussion on utilization & concurrent review, case & demand & population & disease management . Paper 3 of an 8 paper series on 'An Introduction to Care Management Interventions and Their Implications for Actuaries'.