Description: US pharmacy prices have entered a new era of growth driven by Specialty medications. A bevy of state and national regulations have been proposed to address pharmacy pricing, industry structure and transparency.Health actuaries will learn about US pharmacy pricing structure and how proposed legislation could affect future costs. Actuaries that have responsibility for pharmacy rate/budget setting, RFPs or trend projection will benefit from a deeper understanding of the US pharmacy market landscape and gain an international perspective.

Description: Recent health care reform activity has highlighted the importance of Clinical Integration in improving the quality, safety, efficiency and reimbursement infrastructure of the health care system. This article discusses relevance and implication of regulatory measures, implementation and data issues, and provides an end-to-end example.

Description: In April, 2009, the Chinese government launched the most comprehensive Health Care System Reform ever. The goal: to establish and improve the basic health care system covering most urban and rural residents, and to provide the people with safe, effective, convenient and affordable health care. There is no doubt that this 'Made in China' health care reform will become the world’s most extensive health care system reform because it will inevitably affect many players in the game such as the local governments who currently administrate the program, the medical professionals who provide the care, the pharmaceutical manufacturers who provide the medicines, and the very large population who participate in the program, etc. This article summarizes the highlights of China's health care reform program.

Description: This article summarizes the presentations by the Society of Actuaries and the Academy of Actuaries at the January 2015 National Academy of Social Insurance (NASI) Roundtables in Washington DC. SOA presented on the 2014 SOA monograph series "The Link between Retirement Security and Long-Term Care."

Description: A report on the proceedings of the June 2010 SOA health meeting. Leading topics included health care reform, opportunities to expand actuaries' roles, the global financial crisis, and collaboration with other organizations.

Description: Panelists at this session of the SOA 2000 Las Vegas Spring Meeting discuss the roles of the federal and state governments in regulating health care insurance, the potential overlaps of these jurisdictions, and how insurance companies, health plans, and providers are being affected.

Description: This article summarizes 2012 AAA activities relating to the Affordable Care Act implementation, including work on the Amicus Brief for the Supreme Court Decision, MLR regulations, Actuarial Value, Rate Review, Essential Health Benefits and work with the NAIC.

Description: This article is based on a third party administrator study and explores the relationships between family structure, spare capacity and health care utilization.

Description: Discussion of some of the debated aspects of the new health care law from an actuarial principles perspective.

Description: Savings from biosimilars have accelerated significantly in the past few years. There has been a number of relatively recent biosimilar launches that can help to shape our expectations of the financial impact that could result from this year’s big event. Savings from biosimilars have accelerated significantly in the past few years. There has been a number of relatively recent biosimilar launches that can help to shape our expectations of the financial impact that could result from this year’s big event.