Description: The ACA’s Medical Loss Ratio Provisions

Description: Presenter examines federal and state efforts at parity in the area of mental health insurance. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: In the course of consulting engagements, actuaries almost always find they need one or more of the following resources: -Healthcare data, which may be at the individual patient level or on a particular population. -Health services research studies which describe, summarize, try to alter, or predict patients’ use of health resources. -Health policy information, which describe public or private actions which affect the access, cost and quality of medical care. This document describes the ever-changing resources and specifies where they may be obtained.

Description: Introduction to the ACA @ 5 publication

Description: Report from research project that reviewed and inventoried the range of quality and efficiency measures that demonstrate the performance of hospitals and physicians. Besides outlining key areas of consideration for quality and efficiency measurement, this report also describes future opportunities for actuaries and other health professionals interested in this evolving area. The inventory part of the report is in a separate document.

Description: This is the inventory part of the report from the research project that reviewed and inventoried the range of quality and efficiency measures currently available for healthcare. The goal was to outline key areas of quality and efficiency measurement and identify future opportunities for actuaries. The inventory lists the resources and provides brief descriptions of their services with links.

Description: Research project that reviewed and inventoried the range of quality and efficiency measures that demonstrate the performance of hospitals and physicians. Besides outlining key areas of consideration for quality and efficiency measurement, this report also describes future opportunities for actuaries and other health professionals interested in this evolving area. The inventory part of this report is in a separate document.

Description: The Health Plan Employee Data and Information Set 'HEDIS' is a set of standardized performance measures initially designed to enable purchasers of health care to evaluate and compare a managed care plan’s administrative performance. The National Committee for Quality Assurance, known as the NCQA, developed HEDIS in 1991. Since its introduction, HEDIS has become a widely used tool for measuring a broad array of health plan functions. This study evaluates the reliability and validity of HEDIS measures. It also reviews the usefulness of HEDIS as an indicator of health care quality.

Description: This is the inventory part of the report from the research project that reviewed and inventoried the range of quality and efficiency measures currently available for healthcare. The goal was to outline key areas of quality and efficiency measurement and identify future opportunities for actuaries. The inventory lists the resources and provides brief descriptions of their services with links.

Description: CLASS Act and ACA