Description: An actuarial model that provides financial incentives to providers to offer patients an approach that can reverse chronic disease and reduce health care costs

Description: The medical scheme approach adopted by several African countries has failed to meet the needs of those in informal employment and rural communities. This is partly due to affordability amongst these individuals as well as a lack of awareness of how healthcare financing products work. Community based healthcare organisations have achieved greater levels of success in this regard by carefully incorporating the peculiarities of communities in benefit design and involving community members in the management of these healthcare solutions. There are lessons to be garnered from the countries where these have been implemented with some level of success. Even as countries aim towards universal health coverage, observing the unique needs of different communities within a country is essential to ensure resources are utilised efficiently and that healthcare needs are targeted effectively.

Description: This paper will examine why CSR defunding produces pricing uncertainty and how regulators can alleviate these risks when insurers price 2020 premiums.

Description: Summary of common mistakes made by actuaries developing ACA rate filings. Outlines correct approach to ACA rate filing process. Suggests Peer Review process.

Description: Explanation of Medicare Advantage STAR rating program as it relates to payment rates for MA bids. Also describes important features of the program from an actuarial perspective, how the components of the STAR rating are calculated and implications and considerations for actuaries.