Description: An overview of the issues behind reimbursing providers on a bundled or packaged basis. The article presents the potential advantages offered by the proponents as well as the criticisms and obstacles to implementing this type of payment system.

Description: LEARN is an offering to regulators about reinsurance. This article summarizes a session held for Brazilian health regulators in the fall of 2022.

Description: This session will review the challenges the Affordable Care Act has faced since its enactment in 2010 and will look forward to where it’s headed in the future. Panelists will discuss current ACA legislative and regulatory activities as well as ongoing ACA litigation.

Description: This actuarial memorandum represents the first, formal actuarial opinion regarding the reasonableness of the premium estimates the Clinton Administration presented with its proposed Health Security Act. The memorandum presents the assumptions and methods used to develop an average 1994 premium estimate for the standard benefit package.

Description: Summary of results of a 2010 Health Section survey of actuaries and Medicare population, on ways to bend the cost trend curve downward. Issues included transparency, quality measures, fraud and abuse, provider payment, malpractice, medical errors, consumer education, and the pros and cons of employer-sponsored coverage.

Description: Transcript of the Q&A period from Session 6B: Health Status and its Impact on Mortality

Description: The moderator will review senior health products: Medicare supplement, Medicare risk, hospital indemnity policy HIP, cancer, accidental death AD, and employer continuance. Discussion will include product design, pricing, administration, regulation, and marketing. From the Record of the Society of Actuaries, Vol. 21, No. 1.

Description: In this discussion, experts in specific areas reported on recent and current happenings in their field. These include HMOs and manged care, Congressional legislation initiatives, disability insurance and mergers and acquisitions within the health providers/insurers. From Record of Society of Actuaries, Vol. 22, No. 2.

Description: In the course of consulting engagements, actuaries almost always find they need one or more of the following resources: -Healthcare data, which may be at the individual patient level or on a particular population. -Health services research studies which describe, summarize, try to alter, or predict patients’ use of health resources. -Health policy information, which describe public or private actions which affect the access, cost and quality of medical care. This document describes the ever-changing resources and specifies where they may be obtained.

Description: Dental care is an important component of everyone's health, and senior citizens are no exception. With no public dental coverage under traditional Medicare, seniors must seek other ways to obtain dental insurance, pay for services out of pocket, or go without care. In this session we will review the importance of oral care to overall health, the current state of public and private dental insurance for seniors, and innovative ways to reach this population. Medicare, Medicare Advantage, Medicaid, and other types of dental coverage will be discussed by three actuaries with different areas of expertise in the senior dental market.