Description: Risk Adjustment continues to be a hot topic in Health Insurance since its emergence. This mechanism came into being as a means of reducing the risk of selection, particularly in marketplaces where underwriting is not allowed, and rating factors are significantly restricted. Risk adjustment serves to adjust premiums to reflect the risk of individual members or overall members as a whole within a particular cohort of a health plan. Risk adjustment is not perfect, as it does not perfectly predict future costs or perfectly adjust for the differences in expected costs. Different marketplaces have different challenges with risk adjustment.

Description: On February 15, 2022, the Association Forum Health Care Collaborative, a collection of metropolitan Chicago based Healthcare associations, held its winter event. This virtual gathering featured two sessions titled: “Healthcare Policy Perspective” and “Megatrends and Tipping Points that will Define Success in the "New Normal".

Description: The Deficit Reduction Act of 2005 established the nationwide expansion of a Long–Term-Care Partnership program into which any state can choose to participate. This article describes that program and what it means for a person insured under a qualifying long-term-care insurance policy.

Description: Following recent SOA Research, we look at how climate scenarios will affect Long Term Care assumptions and business.

Description: Guidance and a model for actuaries to use when performing their professional services related to Medicaid (Title XIX) and Children’s Health Insurance Program (CHIP or Title XXI) managed care capitation rate setting.

Description: The Casualty Actuarial Society, Canadian Institute of Actuaries, and the Society of Actuaries' Joint Risk Management Section and the Joint Risk Management Research Committee are pleased to make available a new report on the application of ERM. Authored by Bonnie-Jeanne MacDonald, Sim Segal, Michael Wolfson and Heidi Walsh, the report provides a novel demonstration on how ERM can be applied to serve the Canadian public by informing decision makers on the risks facing the current and future delivery of long-term care.

Description: The SOA’s Health Care Cost Trends Strategic Research Program highlights trends in health care costs and high cost claimants, impacts of population driven risk factors on health care costs and innovative approaches to keeping costs in check.

Description: The SOA Research Institute has executed research for over twenty years on some repeating themes and topics. The reports build on each other and add content. This article summarizes and discusses a summary report on long-term care, caregiving and housing linked to long-term care and caregiving.

Description: This report illustrates employer group commercial health care costs and trends from 2013 – 2017.

Description: Learn more about the reasons for provider consolidations and shortages as well as their impact on health care morbidity.