Description: A proposal to reform the health care provider payment system through: a national fee schedule, shifting more reimbursements to primary care providers, better integration of hospital & physician fees, evidence based care, pay for performance, and a better provider risk sharing mechanism.

Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: Since health care reform has made accountable care organizations a hot topic, an SOA workgroup is addressing relevant questions, including provider risk under various ACO models, limitations of the Medicare model for motivating change in the health care delivery system, strategic priorities, attribution of members, meaurement, and the roles actuaries can 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: Rhode Island’s unique “global Medicaid waiver” pursues a potentially dangerous national policy trend: long-term care LTC rebalancing without strong eligibility controls. Resulting cost overruns could seriously damage the state’s social safety net. To maximize the global waiver’s opportunity, minimize its danger, and become a LTC financing model for the country, policy makers need to recognize the issues discussed in this report and pursue the recommended additional research and analysis.

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: Discussion of the impact of the ACA on RBS and required surplus for a health plan

Description: Update on the Long Term Care Section activities, including new council members, research, and educating policymakers, the public, and other industry associations on developments in health care regulation.

Description: Update on Health Section research projects and topics, including health care reform, complexity science, and strategic planning.

Description: A report on the proceedings of the June 2010 SOA health meeting. Leading topics included health care reform, opportunities to expand actuaries' roles, the global financial crisis, and collaboration with other organizations.