Description: This study was sponsored by the Society of Actuaries Health Section. This paper explores the relative significance of aging as a determinant of financial cost of health care beyond age 50, with particular attention to the effect for ages 65 and older. The paper presents concepts of aging factors and aging curves, which define relative values between ages for utilization or cost of health care services. General conclusions are drawn from Medicare data that utilization and cost differ by age, but that aging factors vary across services and may be less significant at very old ages. The author then turns to the question of measuring the significance of an aging curve assumption and what accuracy is lost in the simpler alternative of a single value across an age range.

Description: The article gives actuaries an introduction to Academy Health, the notable health policy research organization.

Description: This session discusses affordable health care including cost drivers, trends, the uninsured, federal funding and state initiatives. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 109

Description: Beginning with the 2019 Benefit Year, CMS (the Centers for Medicare and Medicaid Services) has provided guidance that allows Medicare Advantage Plan Sponsors much greater flexibility in tailoring benefits to promote clinical, care management, and financial goals. The guidance allows for a broader menu of supplemental benefits and also enables plans to target benefit enhancements to beneficiaries afflicted with specific disease states. This session explores the ramifications of the policy changes on Plan Sponsors and beneficiaries, and discusses the different ways that Plan Sponsors are taking advantage of the additional flexibility.

Description: This presentation is an open forum from the 1991 Meeting of the Society of Actuaries, held June 3-5 in Colorado Springs. The panelists debate on who should pay for medical care for the uninsured, and how it should be financed. The debaters represent advocates of private, voluntary, and cooperative private state solutions and state or government intervention to finance health care for the uninsured. Discussion from participants is included. From the Record of Society of Actuaries, Volume 17, No. 3B.

Description: The big event of 2023 is the launch of multiple Humira biosimilars, which began in January with the arrival of Amgen’s Amjevita on the market. The launch of Amjevita kicks off the process of changing the specialty drug marketplace in the United States. The expectation of the full impact of this big event is very hopeful, but there is still uncertainty several months after its beginning. Humira is the highest-selling drug in the world and has been since 2013 (Figure 1)—except for when COVID-19 projects temporarily surpassed it. The world is eagerly awaiting the launch of multiple biosimilar drugs to compete with Humira and hopefully bring more competitive pricing to the benefit of payers and patients everywhere.

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: Part 1 of a 2-part series exploring implementation issues for the Mental Health Parity and Addiction Equity Act of 2008 MHPAEA. Part 2 addresses the new enforcement safe harbor, how the regulations could impact the business of behavioral health care and the impending decisions for payors, employers, providers, and insureds.

Description: The article describes the Health Sections strategic initiative for Public Health and the role of the actuary.

Description: Savings from biosimilars have accelerated significantly in the past few years. There has been a number of relatively recent biosimilar launches that can help to shape our expectations of the financial impact that could result from this year’s big event. Savings from biosimilars have accelerated significantly in the past few years. There has been a number of relatively recent biosimilar launches that can help to shape our expectations of the financial impact that could result from this year’s big event.