Description: Description and specifications for the health section's article-writing contest on the topic of provider payment reform.

Description: Medical management programs have traditionally addressed more acute and short-term issues with chronic disease. As LTC becomes an important product in the insurance industry, including disease management is likely to be valuable for reducing costs and prolonging the healthy, premium-paying portion of a claimant's life.

Description: Recently, the SCAN Foundation, AARP, LeadingAge, and HHS funded economic modeling conducted by Milliman and the Urban Institute around LTC reform elements. The LTC industry has over the years also generated ideas to address the on-coming expansion of LTC needs in the U.S. For this article, we have brought together three individuals who have long involvement with LTC financing to discuss some of the recent ideas and provide some perspectives on their pluses and minuses.

Description: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate health care policymakers on issues including health care reform, Medicare, loss ratios, premium review, reinsurance, benefit and eligibility changes, exchanges, and risk based capital.

Description: An actuarial model that provides financial incentives to providers to offer patients an approach that can reverse chronic disease and reduce health care costs

Description: This article from major US payers describes palliative care as a scaleable means of improving quality and reducing costs during serious and complex illness.

Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: Insurers are becoming increasingly involved in the development and marketing of prepaid health care service plans, or Health Maintenance Organizations HMOs. The article describes four different approaches for establishing capitation rates for HMOs 1. Integrated Budgeting Approach, 2. Inventory Approach, 3. Group Insurance Rating, and 4. Actuarial Approach.