Description: The SOA’s research objective is to provide guidance to state exchange officials and administrators, federal officials and administrators, and actuaries assisting states and health plans. The goal of the project is to estimate the morbidity and/or cost for newly insured individuals in the individual market (and to some degree, the small group exchange) relative to the morbidity and/or cost for the current commercially insured population. This analysis will primarily focus on the individual, non-group market. In order to plan for the impact that these currently uninsured individuals will have on the health insurance markets, it will be important to understand their costs relative to the costs for people already enrolled, for whom many health insurers have experience and data.

Description: The Canadian public health care delivery system continues to experience growing needs for increased funding. The total health care delivery system today costs Canadians $98 billion a year or about 9.7 percent of GDP. Of that total cost, 71 percent is paid by the government, which means the taxpayers. While that may pale in comparison to the costs in the U.S., it does make the Canadian system one of the five most expensive health care delivery systems in the world. While today’s cost pressures are of major concern, of even more concern are the costs being projected by many participants in the current health care debate for the period when the Baby Boom makes higher demands on the Canadian health care delivery system. Traditional projection methods, however, do not differentiate between the elderly who survive the year versus those who die as to their use of health care systems. This paper first looks at the impact that this differentiation could have on projected costs. Second, the paper looks at the impact that the wide use of Advance Directives [also called Living Wills] might have on future health care costs and some of the issues surrounding their use. From Actuarial Research Clearing House 2004, Vol. 1.

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: To advise the management of a company on the most prominent disruptors that are going to increase its health expenditure in the next 5 years.

Description: The objective of this project is to summarize the existing literature on end of life issues of interest to actuaries, and to document a broad list of such articles. The end of life issues explored are multi-dimensional and from multiple perspectives. When considering cost implications of end of life care, it is necessary to consider cost in a broad context as it is a measure that cannot solely be defined by dollars. Other dimensions of cost, such as quality of care, family care giving, communication, patient preferences and access to care, should also be explored.

Description: A report analyzing the cost of care for deceased cancer patients over the last six months of life.

Description: The Society of Actuaries Health Benefit Systems Practice Advancement Committee sponsored this review of recent academic literature on the US healthcare system covering quality, access, costs

Description: On March 6, 2023, The Wall Street Journal hosted its Health Forum, a hybrid all-day event. The virtual meeting featured 11 different events. This white paper focuses on those events. The sessions were informative and fast-paced, with each one providing a quick hit of relevant and cutting-edge information around health care.

Description: This is the databook for the "Health Care Cost - From Birth to Death". This study used commercial data held by the Health Care Cost Institute (HCCI) and Medicare fee-for-service data to analyze health care cost differences by age and their contribution to overall health care cost change. The commercial data includes claims from 2002 through 2010 and the Medicare data includes claims from 2006 through 2010.

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.