Description: Health care reform will require health insurers to change the way they make decisions on what to sell while remaining financially sound. The new regulatory reality of expanded access to coverage leaves insurers with fewer options for managing costs and business risk. With the introduction of risk adjustment mechanisms in the exchanges, the most profitable members will not necessarily be the lowest cost ones, but rather, the members which the health plan is relatively more effective at servicing. While Patient Protection and Affordable Care Act 'PPACA' prohibits underwriting and using any health status information for denying coverage or varying the premium rates, this article describes how the use of consumer data will affect the way health insurers make decisions on what products to sell.

Description: Part II of a two-part series discussing individual market evolution from before the ACA through President Trump's first term.

Description: This article discusses future benchmarks of Medicare and Medicare's rising costs and its relativity to the actuarial profession.

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 session making health care more affordable through health care reform, changes to tax policy, and managed care. From Record of Society of Actuaries Vol. 18, No. 4B.

Description: This article presents the concept of comprehensive care management as a fundamentally different way to reform health care and reduce costs. There are 3 components - demand management, utilization management and disease management.

Description: This article describes the Health Insurance Providers Fee implemented through Section 9010 of the Affordable Care Act (ACA) and discusses how the fee will creates challenges in Managed Medicaid Rate development. It also offers some suggested ways to include the fee in Managed Medicaid rates.

Description: Panelists discuss major reforms of health care financing and delivery systems around the world. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: The Society is taking a hard look at its members’ needs and our future as a profession. Two recent studies have focused attention on the building of our future: Report of the Task Force on the Future of the Actuary and Report of the Task Force on Strengthening the Profession. Both reports discuss the importance of our profession in health care matters. But, neither report is designed to address the practical issues involved with building toward our future in health care.

Description: At this 1992 panel discussion, the panelists, including Congressman Dan Rostenkowski, Chairman of the House Ways & Means Committee, discuss health care and comment on some of the health care proposals that are currently on the table, including the Administration's plan for overhauling the health care system. From the Record of the Society of Actuaries Vol. 18, No. 1A.