Description: This paper presents a different approach to measuring Health Expectancy, especially as it relates to the elderly population. This new actuarial approach is described and numerous examples are given.

Description: Most health care delivered in the United States is based on the acute care model: it is episodic has a beginning, middle and end usually the patient recovers and interventions are designed to target a specific pathophysiologic abnormality. Chronic disease care, in contrast, often has no clear beginning and no end the focus is on managing over the long term with prevention of progression and complications. Further, many chronic diseases “travel together” comorbidities: for example, diabetes, hypertension, coronary artery disease CAD, heart failure, cerebrovascular disease, peripheral arterial disease and renal dysfunction are often found together.

Description: Separating incident and prevalent populations is useful, but the use of a cohort to make an RTM adjustment is unwarranted in the population-based pre- versus post-period design. From Financing Chronic Care Monograph, M-HB05-1.