Description: The Society of Actuaries (SOA) commissioned Milliman to develop this report to provide health care stakeholders—patients, payers, policymakers and actuaries—with a comprehensive description of DPC as well as an objective actuarial evaluation of certain claims made about the DPC model of care.

Description: Health care cost trends are a key ingredient that health care actuaries use in their practice. In collaboration with the Health Care Cost Institute (HCCI), the Society of Actuaries has put together a data extract for practicing health actuaries to be able to better understand historical trends and cost disruptors.

Description: Unmet needs and implications for long-term care financing in Singapore.

Description: The Canadian Institute of Actuaries (CIA) and the Society of Actuaries (SOA) are pleased to make available a resource model that provides long-run (to 2050 and beyond) forecasts of health care spending in Canada.

Description: This research report provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud.

Description: As part of an upcoming Society of Actuaries (SOA) research release to model health care costs in 2020 and 2021, a set of “Return Stages” were created in order to define the various level of activities being observed, as well as to contemplate the ways these stages may progress as various cities, counties and states release their own phasing processes for returning their jurisdictions to normal.

Description: In the United States, individuals needing long-term services and supports (LTSS) access care, utilize services, and pay for their services in various ways. The authors explore how the need for, utilization of and payment for long-term services and supports differ in the U.S. by population cohorts. Their primary focus is disparity by race and ethnicity, but they also consider variations by geography, family structure, age, sex, gender and other socioeconomic factors.

Description: The Society of Actuaries has developed and released a health care forecast model to illustrate the potential impact of the COVID-19 outbreak on insurance plan health care costs in the United States. Users of the model may include insurance company actuaries seeking an additional reference point for 2021 cost development, regulatory actuaries seeking additional insights and validation of costs as part of rating submissions for 2021, and insurance purchasers seeking a deeper understanding of the forces driving 2021 health care costs and premiums. The model is not intended as a replacement for existing modeling tools developed by insurers or regulators. Rather, the model’s primary purpose is to illustrate the key outbreak-related forces that are affecting the trajectory of health care costs. In addition the model can provide a common reference point to facilitate dialogue with respect to the regulatory review of 2021 health insurance rate filings.

Description: This SOA report describes the components of margin for calculating capitation rates in a Medicaid context along with practical issues that MCOs may face.

Description: This paper helps the audience understand the actuary’s role in estimating the financial impact of primary care programs. In addition, the paper can be used by actuaries to think about key issues when estimating the financial impact of their employers’ and clients’ own primary care programs.