Description: This session discussion legal liability for unfavorable medical outcomes, effect of utilization review on the quality of care and patient/provider acceptance, protocol development and implementation for managed care, and insurance coverage necessary to protect your organization. From Record of the Society of Actuaries 1987 Vol. 13, No. 1.

Description: This paper introduces a single measure combining cost and quality of healthcare. This is used to demonstrate the magnitude of the challenge of the increasing dependency rate. It is then used in assessing a number of alternative financing models, including user fees and alternative compensation methods for physicians. The paper documents implementation issues and evaluates the desirability of implementing these approaches in Canada.

Description: Presented at August 2011 46th Actuarial Research Conference. Discussion of research in progress which examines and validates the use of PRIDIT as a hospital quality measure. PRIDIT is an unsupervised learning technique developed as a fraud detection method.

Description: Essays show a new system that will encompass minor changes to the current health insurance system, it will allow consumers to sign up for Federal Employees Health Benefit Plan and be administered like Medicare but with more benefits and emphasis on preventive care.

Description: In this session, panelists present their views on the future of managed care in light of the current environment. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 118