Description: Provides a summary of recent proposed regulations for the health insurer fee, section 9010 of the Affordable Care Act (ACA).

Description: This session is about regulatory constraints and the role the NAIC is playing to help facilitate 24-hour programs, plan design issues, the use of managed care, coverage as part of a workers' compensation plan versus coverage of health care outside of the workers' compensation system. From Record of Society of Actuaries Vol. 18, No. 4A.

Description: This session is about health risk adjustments. Health care reform issues and Society of Actuaries research activities will also be discussed. From Record of Society of Actuaries Vol. 20, No. 3A.

Description: Research report sponsored by SOA to model and compare projected costs of different proposals for a Medicare prescription drug coverage plan. 3 types of costs are studied: net benefit cost estimates per member per month, continuance table data, and projected annual costs to the government over 10 years for two selected plan designs.

Description: Panelists with close ties to prescription drug programs provide information such as factors driving pharmacy cost increases, combating rising utilization, and the value of mail-order drug programs. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 53

Description: An economic analysis of bariatric surgery and health care costs supports the case for health plans to cover these procedures.

Description: Health care predictive analytics varies between payers and providers as well as being a powerful tool in business decision modeling.

Description: Rising drug—and, to a lesser extent, health care—costs in Canada are creating long-term challenges for not only governments and employers across Canada but for individuals as well, with no easy answers.

Description: Most health care delivered in the United States is based on the acute care model: it is episodic has a beginning, middle and end usually the patient recovers and interventions are designed to target a specific pathophysiologic abnormality. Chronic disease care, in contrast, often has no clear beginning and no end the focus is on managing over the long term with prevention of progression and complications. Further, many chronic diseases “travel together” comorbidities: for example, diabetes, hypertension, coronary artery disease CAD, heart failure, cerebrovascular disease, peripheral arterial disease and renal dysfunction are often found together.

Description: Essay states a competing American ideals for the U.S. Health care system include free markets which foster competition, cost effectiveness and quality health care vs.public and private assistance which provides health care independent of a person’s financial means.