Description: Panel discusses the effects of reduced payment levels to many Medicare managed care organizations. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: This study was sponsored by the Society of Actuaries Health Section. This paper explores the relative significance of aging as a determinant of financial cost of health care beyond age 50, with particular attention to the effect for ages 65 and older. The paper presents concepts of aging factors and aging curves, which define relative values between ages for utilization or cost of health care services. General conclusions are drawn from Medicare data that utilization and cost differ by age, but that aging factors vary across services and may be less significant at very old ages. The author then turns to the question of measuring the significance of an aging curve assumption and what accuracy is lost in the simpler alternative of a single value across an age range.

Description: There is a wide range of literature on aging and health care. We sample this literature and find it fits into the subcategories of theoretical aging, medical significance of aging, treatment of the elderly, and resource allocation to the elderly. Themes are that financial arrangements can cause inefficient and ineffective care and that care guidelines need to developed specifically for the elderly rather than extrapolating guidelines for younger patients.

Description: This article focuses on mandatory supplemental benefits offered by general enrollment plans and Dual Eligible Special Needs Plans (D-SNPs) Medicare Advantage plans from 2017 to 2021.

Description: Beneficiaries who are eligible for both Medicare and Medicaid often have complex health needs. The two programs have not typically been well integrated and care can become uncoordinated, fragmented and incomplete. The ACA includes provisions to address the shortcomings.

Description: This one page paper highlights the results of the various comparisons for both R2 and MAPE at the individual enrollee level.

Description: This article focuses on the capitation rate development methodology for the Medicare-Medicaid Financial Alignment Demonstration. It also describes the background behind the establishment of the initiative and how it will be evaluated.

Description: This article compares the Prescription Drug Plan (PDP) market to the commercial individual market exchanges included in the Affordable Care Act. PDP carrier actions to date could help predict certain aspects of the exchange market.

Description: This article makes organizations entering the MA market aware of the star rating climate, as well as short- and long-term star rating & revenue considerations.

Description: Strategies to position Medicare Advantage plans for success during August resubmission.