Description: This session discusses items being promoted by the administration, other politicians, and others interested in the outcome of health care reform. Included is the possible effect on private LTC insurers, LTC taxation, and reporting requirements. From Record of Society of Actuaries Vol. 20, No. 3A.

Description: Panelists will discuss and stimulate audience discussion on the potential roles and opportunities for actuaries during and after health care reform. Included is a perspective from Cananda's experience. From Record of Society of Actuaries Vol. 20, No. 3B.

Description: The panel offers a recap of the most recent initiatives being proposed for reform of the Medicare program. Items addressed include areas of actuarial concern, potential impacts on the insurance industry and responses initiated by the actuarial profession. From the Record of the Society of Actuaries, Volume 30, No. 1, Session 48

Description: The panel offers a summary of the Medicare Modernization Act signed into law in 2003, which implemented sweeping changes to the Medicare program. Topics include Medicare Advantage, the impact on Medicare Supplement, Part D, and the impact on retiree health plans. From Record of Society of Actuaries, Vol. 30, No. 3, Session 127

Description: This session dealt with Regulatory Considerations in Group Insurance. Topics included: 1. National health insurance. 2. Federal hospital cost control programs. 3. Non-discrimination legislation and regulation. 4. Multiple- employer trusts. 5. Impact of recent OASDI financing changes. 6. Changes in mandatory retirement age on group insurance.

Description: There have been a variety of proposals related to expanding eligibility for Medicare, ranging from a publicly funded program to a full buy-in option. This session will explore the actuarial implications of various buy-in proposals and the potential impact that such policy changes could have on the health care market landscape. In particular, we will discuss the ways in which program eligibility requirements, plan designs, provider reimbursement arrangements, network design, rating rules, and subsidies could affect premium levels and membership volume in a Medicare buy-in market, as well as the potential side effects on providers and existing health care markets.

Description: This presents the results of a May 2010 survey by the Society of Actuaries SOA asking members of the SOA Health Section for their opinions on ways to bend the cost curve in light of the Patient Protection and Affordable Care Act ACA, the new health reform law passed in March 2010.

Description: This session explores the far-reaching changes to how clinical data will be sourced, processed and consumed in many payer use cases including risk adjustment, quality measurement, care management, claims adjudication, prior authorizations, and other payer functions. Robust, interoperable data exchange is a prerequisite for value-based care. Clinical data will be increasingly accessible to augment administrative (claims) data via standardized Fast Health Interoperability Resources (FHIR, pronounced 'fire'), at a fraction of the cost of a accessing a traditional medical record and in real-time. On May 1, 2020, HHS issued a final rule implementing interoperability and the patient access provisions of the 21st Century Cures Act of 2016, although enforcement has been delayed into 2021 because of the COVID-19 pandemic. The new regulations promote, “HHS’s vision and strategy for achieving a health information ecosystem within which all individuals, their personal representatives, their health care providers, and their payers are able to send, receive, find, and use electronic health information in a manner that is appropriate, secure, timely, and reliable to support the health and wellness of individuals through informed, shared decision-making, as well as to support consumer choice of payers and providers.”Once enforcement begins, CMS and the Office of the National Coordinator for Health Information Technology (ONC), have the authority to mandate adoption of interoperability requirements, and also penalize payers and providers for non-compliance or the delay and withholding of data.This ‘digital transformation’ of the clinical data ecosystem has far-reaching implications for enabling technologies including Natural Language Processing (NLP) and entire segments of services and vendors. It will eliminate many departmental barriers, duplication and error sources for health plans and impact every department and the underlying economics of delivering and managing care.

Description: This session is about supplemental and specialty health products in Japan, the UK, Canada and Australia. It also includes a discussion on health care reform for individual health and long-term care products. From Record of Society of Actuaries Vol. 19, No. 1A.

Description: This session is about the impact of health-care reform on supplemental health insurance plans such as Medicare Supplement, Hospital, Cancer, etc. The session will also explore new opportunities for supplementary markets and products. Included is a discussion of the CHAMPUS and FEHBP. From Record of Society of Actuaries Vol. 19, No. 4B.