Description: Panelists discuss issues arising from the Health Insurance Portability and Accountability Act of 1996. From the Record of the Society of Actuaries, Vol. 24, No. 1.

Description: Presented at April 1986 Spring Meeting. Defines programs related to providing long-term care for the aging population through Life Care Societies 'LCS', nursing care products, Continuing Care Retirement Communities, etc. and actuarial considerations related to LCS in establishing funding requirements and evaluating liabilities.

Description: At this presentation from Session 7PD of the SOA 1996 Colorado Springs Meeting, the panelists comment on the value they place on ensuring proper management of risk, contract preparation, underwriting and claim handling for long-term care policies. From the Record of the Society of Actuaries, Vol. 22, No. 2.

Description: With the creation of 'qualified' long-term-care plans behind us, companies now have additional information regarding interpretations from the Treasury Department, regulations and directives from insurance departments, and feedback from the consumer. This presentation from Session 128PD of the SOA 1999 San Francisco Annual Meeting looks at what has been learned in the past two years about long-term care insurance and what state and federal regulatory changes may be on the horizon. From the Record of the Society of Actuaries, Vol. 25, No. 3.

Description: This session provides an exploration of the asset side as presenters discuss appropriate investment policies for LTC and asset/liability matching. From the Record of the Society of Actuaries, Volume 27, No. 1, Session 116

Description: This session will explore the national landscape of state Medicaid risk adjustment program design & application and the key differences that drive effective managed care organization program management. Risk adjustment is a mechanism to adjust capitation rates between Managed Care Organizations to account for population morbidity differences. Although many states utilize this mechanism, the application of risk adjustment can vary significantly across states. The primary differences include populations, risk score models and data collection. These state application nuances affect the strategies and tactics utilized by MCOs for effective risk adjustment program management including provider financial alignment, encounter data submission and the capture of accurate diagnosis codes. The session is intended for Medicaid Managed Care Actuaries working to develop or support comprehensive risk adjustment program management functions.

Description: In Medicaid rate development, actuaries have not historically shared models that developed the margin (i.e., underwriting gain) assumption. This is unfortunate, given the margin assumption is one of the most critical components of the rate development in ensuring financial solvency of the Medicaid managed care organizations (MCOs). In this session, we will discuss the primary components of the this assumption and will share working models that help actuaries quantify these components—including the cost of capital and risk (or contingency) margin. We expect a lively discussion as we “open the black box” and discuss these actuarial assumptions in the public for the first time.

Description: Presented at October 1986 Annual Meeting. Discussion covers: how hospitals and hospital management companies are increasingly entering traditional indemnity insurance markets, hospital representatives address health care financing from the hospital perspective, the risks and financial incentives from the hospital's perspective, and whether hospitals are marginally pricing their health insurance products.

Description: The interplay between technology and design to create safe, comfortable and thriving environments for aging in place and managing care costs.

Description: This presentation from Session 111OF of the SOA 1999 San Francisco Annual Meeting covers the new medical technologies and how they affect the price of medicine, the delivery of health care, the cost of care, claims handling, utilization, and cost management. From the Record of the Society of Actuaries, Vol. 25, No. 3.