Description: Discussion of how to mature value-based contracts between health insurers and provider organizations to improve population health and financial sustainability. Centers around contract parameter consistency, revenue predictability and risk assessment. Intended audience are health plan and ACO actuaries and leaders. Authors are writing from the provider perspective in value-based contracts.

Description: What is the difference between a Single-Payer and Universal Health Care System, and how could the U.S. implement a system that would reduce the growth of medical costs while increasing quality.

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: This 1991 open forum discussion is about the resource-based relative value scale [RBRVS] and its impact on physician fee trends [Medicare and non-Medicare], physician specialization, utilization, Medicare supplement plans, employer plans [active and retired], HMOs, and physicians and senior citizens. From the Record of the Society of Actuaries Vol. 17, No. 3A.

Description: Risk adjustment is used to adjust the revenue stream to health insurers that sell ACA eligible plans and Medicare Advantage plans. This article compares and contrasts these risk adjustment programs.

Description: This 1992 discussion is about the resource-based relative value scale [RBRVS]- where it is and where it's going, and its impact on trends, Medicare supplemental coverage, indemnity plans, and health cost projections. From the Record of the Society of Actuaries Vol. 18, No. 1A.