Description: This article focuses on the capitation rate development methodology for the Medicare-Medicaid Financial Alignment Demonstration. It also describes the background behind the establishment of the initiative and how it will be evaluated.

Description: Essay reforming healthcare where participants have a vested interest in reaching the best answer.

Description: Discussion of Medicare's Ambulatory Payment Classification APC system as the standard for reimbursement of non-capitated outpatient hospital services with sample calculations. Issue No. 37.

Description: Risk adjustment is used to adjust the revenue stream to health insurers that sell ACA eligible plans and Medicare Advantage plans. This article compares and contrasts these risk adjustment programs.

Description: Overview of Medicare's 1979 financial projections under optimistic, pessimistic, and intermediate assumptions, for the Hospital Insurance and Supplementary Medical Insurance programs.

Description: Panelists discuss what they are seeing in today's market in respect to HMO group products offered to employers alongside their individual Medicare product. From the Record of the Society of Actuaries, Vol. 25, No. 2.

Description: This session disscusses thel outlook of the Medicare program, current and longer-term reform proposals, and Medicare prescription drug proposals. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 66

Description: Congress has been debating a revision to Medicare Advantage payments including limiting payments to the Medicare Fee-For-Service FFS cost. A county-specific impact study to the benchmark payment rates for each county nationally based on the FFS limitation criteria was performed. This article includes results for Florida, California, Pennsylvania and New York.

Description: This session discussion is about Madison's and Reagan's influence on the constitution and government of the United States and how that impacts the future of the Medicare program. The traditional Medicare program complimented by Prudent Purchasing Reforms is compared to the Private Health Plan Option. From Record of the Society of Actuaries 1987 Vol. 13, No. 1.

Description: Analysis of possible mathematical relationships between hospital quality and hospital billed or allowed charges or other measures, using quality data as defined by the U.S. Department of Health and Human Services along with the Hospital Quality Alliance for their Hospital Quality Initiative.