Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: This session discussion is about two proposals for health-care reform will be presented, one from the Blue Cross/Blue Shield Association and one from the Council for Affordable Health Care. These dramatically different proposals will be compared and open for critique. From Record of Society of Actuaries Vol. 18, No. 4A.

Description: This session is about regulatory constraints and the role the NAIC is playing to help facilitate 24-hour programs, plan design issues, the use of managed care, coverage as part of a workers' compensation plan versus coverage of health care outside of the workers' compensation system. From Record of Society of Actuaries Vol. 18, No. 4A.

Description: Panel discussion of prospects for cost containment of, and alternatives to, fee-for-service health care, and management of health care under national health insurance. Discussion points include cost containment devices, HMOs, economic impact, cost escalation, self-insurance, stop-loss, claims administration, loss of state premium taxes, and Phase 3 tax problems under NH1.

Description: This session discussed about expected trends in medical care costs, changes in Medicare reimbursement practices and their short- and long-term effects, the emerging responsibility for providing long-term care, rise of managed health care, new and old participants, selection issues, multiple options, and small group market.

Description: Mental health spending has reached $147 billion in the United States with demand only increasing greatly impacting society as nearly 1 in 5 experience these issues. There are even more indirect costs associated with mental health causing a national crisis surpassing 1 percent of the GDP. These costs coupled with the severe lack of licensed clinicians calls for an innovative solution. Through years of development and completion of a randomized controlled trial, Prevail has built and validated a low-cost, scalable solution. Prevail's clinically proven digital mental health treatment provides increased access to care while reducing overall health costs. Private and public payors should being reimbursing this model and offering it to their members.

Description: Essay discussing that the two factors that affect healthcare cost are costs and the fact that people lack coverage.

Description: Update on the potential impact of national health law legislation, and discussion of the influence of inflation on both the relation between actual and expected claims, and the design of new benefits and administrative procedures. This presentation was made at the 1975 SOA Los Angeles Spring Meeting.

Description: Presenters discuss the differences between patient treatment protocols and length-of-stay guidelines, and some of the issues that payers confronted as the protocols were implemented. From the Record of the Society of Actuaries, Vol. 24, No. 2.