Description: This article discusses new opportunities for states to waive certain marketplace requirements of the Patient Protection and Affordable Care Act. The article focuses on specific opportunities for states and the role that actuaries will play.

Description: This article contains a condensed summary and excerpt from the fourth white paper in the Commercial Health Care: What’s Next? series.

Description: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate health care policymakers on issues including principles for reform, Medicare, the individual insurance market, and risk factors.

Description: This article is focused on sustainability concerns in the ACA individual markets and what we can learn from core actuarial principles as discussed in ASOPs.

Description: A summary of pathology, risk factors, treatments, public health issues, and economic costs of Alzheimer's Disease.

Description: Presented at the Living to 100 Symposium, January 2011. In India, the prevalence of lifestyle diseases such as diabetes and cardiovascular diseases has been increasing tremendously. This spurt of diseases and the resultant morbidity is severely affecting the quality of life of the elderly. The problem is compounded by a medical and health care infrastructure which is inadequate to meet the challenge. This paper analyzes and estimates, using actuarial tools, the effect on the economy with particular focus on the present and future elderly segment of the population, identifies opportunities for insurers to address the situation, and suggests remedial measures to deal with the situation. Medico-actuarial studies in this area will also be covered.

Description: This article will consider several issues arising from ACO budgeting and pricing of stoploss coverage, including: 1) attribution of members; 2) claim carve outs; 3) ambiguous stoploss terms; 4) providers gaming the system and 5) credibility of data.

Description: This session is about rationing health care. From Record of Society of Actuaries Vol. 18, No. 4A.

Description: Successful healthcare reform: First, it must help that must keep healthy people healthy. Second, it must help people mitigate or eliminate the health-risks associated with unhealthy lifestyle behavior choices, and Third, it must ensure the provision of evidence-based care to those who are ill.

Description: Summary of testimony by an AAA Board member before a congressional subcommittee, as an expert on risk assessment and adjustment, especially in relation to Medicare risk contracting and HMO payments. She recommended: mitigating the geographical region values, credibility weights for payments to health plans, carving out high cost claim segments, reengineering the ACR methodology, shifting AAPCC methodology from fee-for-service toward competitive bidding, and further projects to improve risk methods.