Description: This session will present the findings published in the report released by the SOA on the March 23, 2020, the 10th anniversary of the ACA.This session will provide an assessment and commentary on the viability of the individual and Medicaid marketplaces under the ACA since its inception. Observations will be based on a data-driven analysis of the associations between market characteristics and measureable outcomes indicative of viability. Viability will be measured in the context of achieving the ACA's goal of providing sustainable access to affordable healthcare to the uninsured and underinsured, and will be considered from the perspectives of various stakeholders.

Description: The Affordable Act's risk corridor program is a temporary feature that applies to individual and small group QHPs from 2014 through 2016. Designed to protect insurers against pricing uncertainty, the program appears straightforward but has many subtle consequences. In this article, we review the need for risk corridors, the calculation itself, and the implications that result.

Description: The report looks at the different outcomes for the 50 states from the ACA, in terms of cost and availability of health insurance coverage. It identifies 11 key observations since the passage of the ACA.

Description: The advent of machine learning algorithms has taken predictive analytics and risk scoring to a new level. From gradient boosting machines to k-nearest neighbors regression, the use of these techniques has gained significant traction in healthcare - including health systems like the Cleveland Clinic. This session will discuss the use of predictive analytics to go beyond just assessing the risk of a patient, and instead focus on prescribing a specific intervention of care. In practice, the recommendation of a care plan goes beyond just attributing a score to a patient. It provides physicians and care coordinators the most probabilistic options - e.g. referral to social worker, depression screening, weight-loss program - for positively impacting a patient's future healthcare outcome.

Description: Technical report to accompany Fifty States, Fifty Stories: A Decade of Health Care Reform Under the Affordable Care Act.

Description: View the FAM-25-18 Individual Health Insurance (Second Edition), 2015, by Bluhm and Leida, Chapter 2, Sections 2.1, 2.9.