Description: Panelists discuss the history of this 75-year-old Medical Information Bureau MIB, its very active and data-rich source of medical information, and the services that the MIB offers to clients and other industry groups. From the Record of the Society of Actuaries, Vol. 24, No. 1.

Description: Discusses management principles for the successful application of the underwriting processes of selecting and classifying risks and the actuarial pricing process of establishing adequate and equitable premiums for the risks to be underwritten within group medical business. Has some nice representative data for what a book of business might look like by case size.

Description: The medical scheme approach adopted by several African countries has failed to meet the needs of those in informal employment and rural communities. This is partly due to affordability amongst these individuals as well as a lack of awareness of how healthcare financing products work. Community based healthcare organisations have achieved greater levels of success in this regard by carefully incorporating the peculiarities of communities in benefit design and involving community members in the management of these healthcare solutions. There are lessons to be garnered from the countries where these have been implemented with some level of success. Even as countries aim towards universal health coverage, observing the unique needs of different communities within a country is essential to ensure resources are utilised efficiently and that healthcare needs are targeted effectively.

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: Article discussing the use of enterprise risk management in the health care industry.

Description: This article is intended to inform readers about the current state of mental health and health care in the US, as were it's heading moving forward.

Description: The ACA’s Medical Loss Ratio Provisions

Description: Feature article featuring expert opinions on the future of health care

Description: Feature article with helpful hints on video conferencing and more!

Description: The International Actuarial Association Health Section, the Society of Actuaries International Section, and American Academy of Actuaries (AAA) published the report “International Health Care Funding 2020”. This article highlights the features of the report.