Description: Diabetes mellitus type 2 is an excellent model for assessing the setup of medical coverage in the U.S. health care system. It is a chronic disease that has genetic, behavioral and other medical causes, and causes many complications over the long term. From Financing Chronic Care Monograph, M-HB05-1.

Description: This discussion at the San Francisco 1966 Regional Meetings covers three topics - Disability Benefits under Life or Health Insurance Policies, Changes in Individual Medical Expense Insurance in the Light of Medicare, and Optional Modes of Settlement.

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: The Actuary Vol. 22, No. 3. In this article Deborah Poppel interviews Paul Barnhart regarding the controversies surrounding the proposed heath insurance reserve standards.

Description: This discussion at the San Francisco and Washington 1966 Regional Meetings covers three topics - Disability Benefits under Life or Health Insurance Policies, Changes in Individual Medical Expense Insurance in the Light of Medicare, and Optional Modes of Settlement.

Description: This article provides an overview of critical illness insurance: history, product description, and the three primary ways to offer critical illness coverage in the United States. This article also contains an illustration of an issue age premium rate calculation, as well as product features and rating applications specific to the various types of critical illness coverage.

Description: This panel discussion focuses on effective product management of life insurance. Areas addressed include definition of effective product management, internal organization required, establishment of objectives for a product line, coordination of company activities with respect to initial design, and monitoring.

Description: This chapter focuses on creating practical models that aid in the prediction of the risk of readmission to a specific hospital within 30 days of discharge for Medicare patients, to aid in the identification and stratification of at-risk patients for hospitals considering building an intervention program in a cost-effective manner. For readers who wish to develop their own predictive model, a dataset is provided on the Actexmadriver.com website, and R code is provided in the appendix to this chapter.

Description: Provides an overview of developments in the healthcare market including provider billing practices. Provides an overview of the Government Finance Officer’s Association (GFOA) in New York on Dec. 6, 2018