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: The momentum in value-based care has produced an opportunity for actuaries to become pioneers in health care

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

Description: The summary and introduction of an SOA research paper that explores valuable insights and recommendations for insurance companies considering entering the market of commercial long-term care insurance (LTCI) in the Asia-Pacific, based on individual health status.

Description: This article describes Medicare Supplement and short-term care products in more detail, and we compare their risk profiles. We explore the concept that these two products—when offered together—may provide a complementary hedge of certain policyholder behavior risks.

Description: This article discusses how small insurance companies can get into the complex equity indexed market by using alliances wherein there is one primary company and one or more secondary companies. The primary company would perform all of the functions for itself and some of the functions for the secondary companies. The companies pool assets to reach critical mass.

Description: This is the first in a series of articles about accounting for reinsurance under GAAP Targeted Improvements to the Accounting for Long-Duration Contracts (LDTI). It provides an introduction to the topic, giving an overview of what has and hasn't changed. Changes include a few that directly address reinsurance and others that indirectly result from changes to direct accounting and the existing ties between reinsurance and direct accounting.

Description: Discover the key components of value-based care (VBC) contracts and their impact on provider credibility. Learn about benchmarks, measurement period results, and the unique challenges providers face in managing insurance risk. Gain insights into reducing costs and aligning financial incentives in the US healthcare market.

Description: As an addendum to a July 2022 article, this article restates the formulas then presented for a framework to measure the reinsured portion of a direct loss from capping a net premium ratio or flooring a liability. The article corrects a flaw in one of the original formulas and shows, by example, how the framework can be applied to a specific application of reinsurance accounting.

Description: The article provides a summary of key issues presented at the 2023 U.S. Living to 100 Symposium focused on the interests of retirement professionals and retirees. It provides an overview of the subjects covered. The discussion focused on the well-being of retirees and the development of the retirement system. It is focused on late-in-life issues and having the best life possible during that period. It balances technical and lifestyle issues, with an emphasis on mortality and longevity trends and influences. Some of the topics discussed include the impact of COVID, climate, housing, and age-friendly communities. The Elder Tech Symposium was merged into Living to 100 and includes discussion of a variety of technology approaches to improve lives and simplify support. The symposium recognized that the decisions needed and concerns during retirement are different later in life, particularly as people decline.