Description: An introduction to the ACA@10 Strategic Initiative, which examines the impact of the Affordable Care Act 10 years after its passage.

Description: Profile of an actuary in a non-traditional actuarial role: focusing on medical cost and analysis, both retrospective and prospective.

Description: Companies with the intention of being the top, trusted source(s) in an information overloaded world.

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: Help to generate ideas for formulating a pricing strategy of 2015 individual health insurance products despite having very limited claims and premium experience in early 2014.

Description: Bringing managed care concepts into LTC claims management could benefit insurers, policyholders, and providers. This article outlines the case for doing so, and articulates the benefits to each stakeholder in the LTC claims process.

Description: The Triple Aim is a vision to improve the health of populations, create a better quality of life, and reduce per capita spending for the benefit of communities.(http://www.ihi.org/Topics/TripleAim/Pages/default.aspx) While much public attention on wellness has focused on topics such as obesity and smoking, it would be beneficial if greater emphasis was placed on raising the bar of oral health. The mouth plays an important role in overall health and wellness. Routine oral care helps prevent dental problems and appears to positively affect chronic conditions before they develop into complex, more expensive ones. This purpose of this session is to increase awareness of the importance of oral health, the consequences of poor oral health, and the link with socioeconomic characteristics. This session will explore and highlight studies completed in this space by both researchers and payers. Actuaries interested in learning more about the impact of oral health and overall health, relevant interventions that have been undertaken, areas for potential financial savings, and issues relating to public policy applicable to oral health would benefit from attending this session.

Description: Review of a report by Alan Mills introducing Complexity Science, a discipline which could help actuaries to model and manage complex systems, such as the health care system.

Description: This is a case study session where the speakers will describe a project where a major health system converted its provider distinct reimbursement (i.e., separate physician IPA and hospital capitation) to an integrated reimbursement involving global capitation. The session will discuss the strategic issues considered by the parties and how they evaluated them in their decision process. This session will provide attendees an example of how to approach this type of decision.

Description: This is one of a series of SOA-sponsored papers on the subject of Evaluating the Results of Care Management Interventions. This paper addresses the theory of measurement design and provides a practical evaluation of the most common designs for the practitioner.