Description: As providers are considering accountable and value based care models, it is critical to strategically think through how to achieve a sustainable business model into the future. This requires actuarial and clinical/provider capabilities to assess the care management and financial levers to help a client through the transition.

Description: The article describes what a Delphi study entails; describes past Delphi studies conducted by the SOA; and summarizes "Land This Plane" - A Delphi Study about Long-Term Care in the United States, which was published by the SOA in April 2014.

Description: The direct and indirect effects of the pandemic have impacted many actuaries’ work since the spring of 2020. This article addresses three considerations actuaries should account for when using risk evaluation models which are focused on projecting remote, highly unlikely losses: model effectiveness, asset risk, and insurance (mortality and mortality) risk.

Description: Profile of an actuary in a non-traditional actuarial role: focusing on medical cost and analysis, both retrospective and prospective.

Description: The comments of DxCG about their participation in the SOA study A Comparative Analysis of Claims-Based Tools for Health Risk Assessment.

Description: Article provides a market scan of recent state proposals for Medicaid work requirements as well as measures the impact to enrollment in different states.

Description: This article describes the use of artificial society modeling to gauge the effect of insurance agent population and effectiveness on individual life insurance sales. This is part of an ongoing effort to extend the use of one type of agent-based modeling beyond health care, but is far from a practical application at this point.

Description: According to the Actuarial Standards Board’s Actuarial Standard of Practice No. 49 (ASOP 49), actuarially sound Medicaid managed care capitation rates will include a provision for underwriting gain in order to provide compensation for the risks assumed by an MCO. However, there is no generally accepted method for quantifying underwriting gain in managed Medicaid capitation rates. This article discusses a new model developed to address this void and calculate underwriting gain. The model was developed by researching existing financial literature and performing a statistical analysis of industry data to build out a framework that can be leveraged to estimate underwriting gain.

Description: View the complete issue for the August 2014 Reinsurance News newsletter.

Description: Regression to the mean is a phenomenon that arises when comparing sequential data points. It states that when an initial observation is extreme or an outlier, future observations will be closer to the average. Health care actuaries need to understand and be able to mitigate the effects of regression to the mean to avoid misapplying predictive models or misstating measurements of historical effects.