Description: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to conduct research and educate health care policymakers on issues including principles for market reform, individual insurance, and risk factors.

Description: Results of an SOA survey regarding the expectation for 2015 accruals for 3Rs and cost sharing reduction payments

Description: A review of the 2009 Health Spring Meeting, which included speakers & sessions on the future of the SOA, U.S. health care reform, claims data issues & improvements, predictive modeling, underwriting principles, employer stoploss, cost trends, LTD & disability, and mental health parity regulations.

Description: This article compares the Prescription Drug Plan (PDP) market to the commercial individual market exchanges included in the Affordable Care Act. PDP carrier actions to date could help predict certain aspects of the exchange market.

Description: This paper will examine why CSR defunding produces pricing uncertainty and how regulators can alleviate these risks when insurers price 2020 premiums.

Description: Summary of common mistakes made by actuaries developing ACA rate filings. Outlines correct approach to ACA rate filing process. Suggests Peer Review process.

Description: A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay less than the true cost while others must then pay more, to a 'value for money' system. This would be achieved by requiring providers to bill all patients the same rate for the same services, with a standard bundling format to make all providers' rate differences transparent. Differences between billed charges and what Medicare pays would be made up by the Medicare patient, rather than subsidized by those outside of Medicare.

Description: Two Medicare risk funding provisions that were radically changed by the BBA of 1997 funding variations by geographic area and risk adjustment. Issue No. 36

Description: Read the November 2016 issue of Health Watch published by the Health Section. Newsletters provide practical information for the working actuary, articles on trends that impact sections and news about section activities.

Description: This article focuses on the capitation rate development methodology for the Medicare-Medicaid Financial Alignment Demonstration. It also describes the background behind the establishment of the initiative and how it will be evaluated.