Description: A proposal to reform the health care provider payment system through: a national fee schedule, shifting more reimbursements to primary care providers, better integration of hospital & physician fees, evidence based care, pay for performance, and a better provider risk sharing mechanism.

Description: A comment letter to policymakers produced jointly by the SOA and AAA presents findings from their actuarial analysis of the proposed CLASS Act. The analysis indicates that the proposed structure and funding approaches will be unsustainable, and will cover only a very small proportion of the intended population. The opt-out and guaranteed issue provisions of the plan pose a risk that soon the program will either need increased premiums and/or significant reductions.

Description: This article presents a view of health care as an economic system, suggests a framework for classifying current criticisms of the system, and offers references for further reading.

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: Report on the activities of the Academy’s health practice council and its work groups.

Description: The editors of Health Watch have made health care reform the focus of the Sepctember 2009 issue, and provide an introduction to the issue's contents.

Description: Open meeting of the Society's Health Benefit Systems Practice Advancement Committee and Health Section Council, as well as the American Academy of Actuaries' Health Practice Council. The three committees review ongoing projects in the Health Practice area. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: Discussion of direct primary care and how it helps with several challenges in health care today. DPC improves care coordination, improves outcomes, improves doctor and patient satisfaction, and reduces spending. DPC successes promote the view that primary care should not be covered by insurance; rather, it should be paid for directly.

Description: An examination of LTCI rate increases from three different perspectives: the insurance company, the policyholder, and the insurance department.

Description: An overview of the issues behind reimbursing providers on a bundled or packaged basis. The article presents the potential advantages offered by the proponents as well as the criticisms and obstacles to implementing this type of payment system.