Description: By rationing heath care resources, managed-care organizations have raised ethical and legal issues not commonly found under previous health-care-financing structures. Panelists, including a member of the Board and the Executive Committee of the American Medical Association [AMA], and the audience debate this issue. From the 1997 Record of Society of Actuaries, Vol. 23, No. 3.

Description: This presentation from Session 15 of the SOA 2005 Health/Pension Spring Meeting discusses current developments affecting health plan contracting with institutional, professional and ancillary providers. Specific questions addressed are: 1. What are the trends in financial arrangements sought by providers?, 2. Has consolidation changed negotiating strategies?, 3. Has technology affected the types of financial arrangements available?, and 4.How can actuaries assist in the analytical/negotiating process?

Description: Experts discuss new strategies related to provider contracting and network management. Topics include various reimbursement approaches and risk-sharing arrangements, unique risk arrangements for certain provider specialties, unique risk managements for specific diseases, and the role of care management/care coordinators. From the 2002 Record of Society of Actuaries, Volume 28, No. 2. Session 59PD of the San Francisco Spring Meeting.

Description: By rationing health care resources, managed care organizations have raised ethical and legal issues not commonly found under previous financing structures. This session 95PD of the Palm Desert Spring Meeting addresses these issues. From the Record of the Society of Actuaries, Vol. 23, 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: The panel will provide an update on current developments in the financial transfer of risk under alternative managed care arrangements. The panel will also discuss the emerging issues with respect to capitation arrangements. From the Record of the Society of Actuaries, Vol. 21, No. 4a.

Description: This session discusses HMOs: do they manage health better, do provider financial incentives reduce quality, do HMOs profit from shadow pricing, and do they attract better risk. From Record of Society of Actuaries Vol. 16, No. 1.

Description: The panel at this session of the SOA 1989 Chicago Spring Meeting discusses managing ambulatory care [i.e. outpatient], physician visit frequency, multiple testing, defensive medicine and how physicians function in a manged care environment.

Description: This session discussion is about employer mandates, state regulations [retirement communities & HMOs, NAIC rate regulation exposure draft ], relations with regulators and relations with health care providers. From Record of the Society of Actuaries Vol. 15, No. 3A.

Description: The panel offers a recap of the most recent initiatives being proposed for reform of the Medicare program. Items addressed include areas of actuarial concern, potential impacts on the insurance industry and responses initiated by the actuarial profession. From the Record of the Society of Actuaries, Volume 30, No. 1, Session 48