Description: This session is about rationing health care. From Record of Society of Actuaries Vol. 18, No. 4A.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: Methods and assumptions used in the valuation of savings by external care vendors

Description: The editorial shares observations and lessons learned from the process of implementing the Affordable Care Act.

Description: Affordable Care Act and Payment Reform

Description: Essential Health Benefits and Actuarial Value

Description: A Regulatory Perspective on Rate Review Before and After the Affordable Care Act

Description: Panel discusses the effects of reduced payment levels to many Medicare managed care organizations. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: An actuarial model that provides financial incentives to providers to offer patients an approach that can reverse chronic disease and reduce health care costs