Description: Using the Health Care Cost Institute (HCCI) database, we examined which characteristics best predict and describe high-cost members.

Description: Chronic Kidney Disease (CKD) affects many lives and has a large impact on health systems around the world. To better understand and predict costs for insurance plan members with CKD in the United States, we built a new model of their individual costs. Our model is the first to explicitly model both the CKD stage transition process and the distribution of costs given those stages.

Description: LTC insurers are beginning to implement population health programs to improve the lives of their policyholders before and during a claim. Measuring the financial impact of these programs can be difficult for a variety of reasons and multiple methodologies are used to evaluate treatments or programs. This article proposes two different methods of randomized control trials to evaluate the impact of these programs through a case study approach, along with additional potential considerations when evaluating effectiveness.