Description: Discussion of direct primary care and how it helps with several challenges in health care today. DPC improves care coordination, improves outcomes, improves doctor and patient satisfaction, and reduces spending. DPC successes promote the view that primary care should not be covered by insurance; rather, it should be paid for directly.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: Methods and assumptions used in the valuation of savings by external care vendors

Description: A humorous look at the spring 2013 activities that a health care actuary working on individual or small group health care reform would be involved in.

Description: This article contains excerpts from the first three articles that were released through the strategic initiative - Commercial Health Care: What’s Next?

Description: This article introduces a research report that studied the relationship of nontraditional variables with health costs.

Description: This article describes Medicare Supplement and short-term care products in more detail, and we compare their risk profiles. We explore the concept that these two products—when offered together—may provide a complementary hedge of certain policyholder behavior risks.

Description: How benchmarking actual performance to a published source is a useful tool in assessing the value added by a particular program or MCO, Issue No. 38.

Description: Health Care in Ireland public care, private insurance, risk adjustment Issue No. 39.

Description: Using Healthcare Claims Data to Create Actuarial Models.