Description: This project would update the Medicaid underwriting model and report to reflect emerging factors that materially impact financial results and Medicaid Managed Care Organization (MCO) risks and incorporate additional up-to-date rate setting and MCO financial data, as well as any new insights within the accompanying report.

Description: What can the United States learn from other countries' health care systems? How are other countries more efficient? We selected five countries that have been among those debated as having some of the most efficient health care systems to explore what the United States can learn from these examples.

Description: This article summarizes a recent session at an SOA meeting that presented tips on improving and speeding the product filing process.

Description: Discover the key components of value-based care (VBC) contracts and their impact on provider credibility. Learn about benchmarks, measurement period results, and the unique challenges providers face in managing insurance risk. Gain insights into reducing costs and aligning financial incentives in the US healthcare market.

Description: Actuaries are leveraging predictive modeling and machine learning more and more as they strive to provide greater value to their stakeholders. Actuarial standards of practice provide guidance around modeling and data. The world has changed significantly over the last few years, so it is important these models be tested for fairness as well as any statistical biases. This article addresses some of the key issues actuaries need to be aware of as Corporations and society work through the responsible us of this technology and underlying data.

Description: Response to March 2021 Practice Note on ASOP 6

Description: This article focuses on mandatory supplemental benefits offered by general enrollment plans and Dual Eligible Special Needs Plans (D-SNPs) Medicare Advantage plans from 2017 to 2021.

Description: Actuaries are currently familiar with the impact of new technologies used primarily by clinicians and health care providers, such as new drugs and devices. The common theme emerging from many of the articles points to a technological revolution in health care accelerated by the COVID-19 crisis this year. Actuaries need to understand these technologies, their impact, learn how to drive this technological change and guide the response of their profession and their own health care organizations.

Description: Electronic Health Records, or EHRs, are a major worldwide initiative to eliminate paper recordings – including Attending Physician Statements (APSs) – of an individual’s medical history and current treatment.

Description: The Health Care Cost Institute (HCCI) recently released their annual health care cost and utilization report on February 13, 2020. This report illustrates employer group commercial health care costs and trends from 2014 – 2018.