Description: This article begins with a comparison of the commercial risk adjuster to the exisiting Medicare model, and goes on to discuss why the existing strategies employed by health plans will not work in a risk adjusted environment. The article elaborates on the importance of diagnosis coding, controlling member mix, and care management in order to mitigate risks and gain from newly created opportunities.

Description: This article explores the changing risk profile between the transitional Affordable Care Act (ACA) period (2014-2016) and under the final ACA period (beyond 2017) for the individual market. Actuaries are in a unique position to help facilitate the change from the current ACA period to the final period when health plans will have to take on substantially more risk.

Description: Author asserts that actuaries are arguably better at analyzing and interpreting risk than any other professional. The exhaustive exams teach us how to manage risk, not eliminate it. If the profession is to continue to flourish, it will be vital to take this idea and apply it to one’s career too.

Description: background history of the insurance industry and the role of actuaries within it, followed by the current environment and anticipated future environment.

Description: This paper introduces a single measure combining cost and quality of healthcare. This is used to demonstrate the magnitude of the challenge of the increasing dependency rate. It is then used in assessing a number of alternative financing models, including user fees and alternative compensation methods for physicians. The paper documents implementation issues and evaluates the desirability of implementing these approaches in Canada.

Description: This article explores implications for the future of improving the application of existing underwriting techniques and and taking maximum advantage of new technologies.

Description: Discussion of the need for long term care reinsurance and the types of services needed and available.

Description: Institutional investors seeking to hedge have no shortage of choices, and need the right framework to manage the different risks in portfolios as they arise. This article analyzes performance of different equity hedging strategies over the last 15 years, and lays out a potential hedging framework that takes into account types of risks being hedged, fundamental views, and current market pricing of protection.

Description: The articles discusses how Principles-based approaches PBA to setting reserves and capital can be combined with Enterprise Risk Management to create a competitive advantage for an insurance company. Those companies can leverage these models by combining unique risks and strategies to measure and manage risk.

Description: This article discusses four approaches to managing the enterprise-wide risk: Diversification, Loss Controlling, Risk Trading and Risk Steering.