Description: This paper discusses the quality of healthcare verses the price of healthcare and puruses individuals and doctors making decisions for their own healthcare costs and services.

Description: A glossary of terms.

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

Description: Social Insurance & Public Finance Section council members provide a recap of sessions from the 2021 SOA Health Meeting, with a focus on sessions covering Medicare, Medicaid, the ACA, and public policy. The authors include a description of SIPF Section-sponsored sections, including a session on the ACA and a session on CMS's Direct Contracting Model.

Description: Essay discussing cost, quality and access of healthcare and then describes the need for rationing.

Description: Changes introduced by various Medicare Alternative Payment Models and the Medicare Access and CHIP Reauthorization Act (MACRA) have accelerated an existing market trend of shifting some of what has traditionally been considered “insurance risk” to providers. The Provider Risk Sharing Boot Camp will give attendees deeper insights into methods, current thinking, and alternative solutions that actuaries can use to help providers understand and manage the financial and actuarial risks that they are taking, many for the first time.

Description: Essay stating accessibility, affordability and efficiency are the key to success in the future of healthcare.

Description: Panelists discuss emerging valuation-actuary-related issues, including: [1] for long-term-care insurance [LTCI], reserves, risk-based capital [RBC], and new experience forms, [2] for Medicare Part D, several potential future changes, and [3] for health insurance in general, the new Statement of Standard Accounting Practice 85 [SSAP 85] and existing SSAP 84, and current activities of the International Accounting Standards Board [IASB] regarding a definition of 'insurance.' Session 27PD of the 2005 Valuation Actuary Symposium.

Description: This session from the 1983 SOA Vancouver Meeting discusses national health policy issues in the U.S. and the impact of these issues on the private health insurance business. Issues include health insurance for the unemployed, non-paying patients and cost shifting, competition versus regulation and DRG prospective pricing for Medicare.

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.