Description: Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the member and increased payments to Medicare Advantage plans. Milliman's HCC prevalence study illustrates the significant variations in HCC prevalence rates by age/gender, geography, and population type and will assist plans in benchmarking the effectiveness of their own diagnosis code capture efforts.

Description: What you need to know about risk scores to be competitive in the Medicare Advantage market.

Description: Summary and analysis of the diseases and conditions exhibited in the Medicare Advantage population

Description: Panelists discuss changes to the Medicare program being implemented by the Medicare Modernization Act. Topics include Medicare Advantage and Part D bidding and actuarial equivalence. From the Record of the Society of Actuaries, Vol. 30, No. 3, Session 101

Description: Provides background about Prescription Drug Plans, PDPs, and the standard benefit package offered under Medicare Part D. It also provides a basic overview of the bid-development process for a PDP and summarizes some general strategies and observations used in developing the 2006 bids that will likely be used for 2007.

Description: Research report sponsored by SOA to model and compare projected costs of different proposals for a Medicare prescription drug coverage plan. 3 types of costs are studied: net benefit cost estimates per member per month, continuance table data, and projected annual costs to the government over 10 years for two selected plan designs.

Description: This article provides an introduction to the Medicare Prescription Drug, Improvement and Modernization Act of 2003 and looks at how the Medicare prescription drug plan will affect the commercial market as well as, what PDPs will offer for benefits and if any will offer supplemental benefits. From Health Section News, March 2005, Issue No. 49.

Description: Panelists review the history of why Medicare has lacked prescription drug coverage and why some of the previous proposals have failed. The session then discusses drug coverage in Medicare Advantage, Medicare Supplemental plans and Part D. From the Record of the Society of Actuaries, Volume 30, No. 1, Session 106pd.