Description: Reinsurance reduces the required capital of the primary insurer but increases that of the reinsurer. Capital is costly. All capital costs, including that of the insurer and the reinsurer, are ultimately borne by primary policyholders. Reducing the total capital of insurers and reinsurers brings down the total capital cost and the total primary policy premium. A reinsurance arrangement is considered optimal—if it minimizes the total required capital. This optimal reinsurance is an attracting equilibrium under price competition. Evidence suggests an inverse relationship between the total required capital and the correlation between the losses held by different insurers and reinsurers. Examples are constructed to examine this and other properties of the optimal reinsurance.

Description: This is the abstract for the paper, The Need for Coordinated Care for Depression, and the Need for Creative Innovation by Stephen P. Melek, FSA.

Description: The adoption of FAS 158 forces sponsors of post-employment health benefit plans to consider how to manage the volatility that changes in medical care inflation create in the other postemployment benefits (OPEB) liability. By choosing carefully how the nominal discount rate used for the liability is decomposed into real rates and inflation, I illustrate that the true exposure to an OPEB plan is to the spread of medical care inflation above (or below) the overall inflation rate. The implication is that an effective immunization strategy exists that can eliminate most of the volatility in the OPEB account.

Description: This paper employs a static-component projection methodology as a first step in a more complex research agenda focusing on developing detailed population projections in which mortality, disability, and disease are represented as linked phenomena with changes in any one impacting the other two. From Retirement Needs Framework, M-RS00-1.

Description: Most health care delivered in the United States is based on the acute care model: it is episodic has a beginning, middle and end usually the patient recovers and interventions are designed to target a specific pathophysiologic abnormality. Chronic disease care, in contrast, often has no clear beginning and no end the focus is on managing over the long term with prevention of progression and complications. Further, many chronic diseases “travel together” comorbidities: for example, diabetes, hypertension, coronary artery disease CAD, heart failure, cerebrovascular disease, peripheral arterial disease and renal dysfunction are often found together.

Description: This is the abstract for the paper, The Boomers Are Coming: A Total Cost of Care Model of the Impact of Population Aging on the Cost of Chronic and Acute Conditions in the United States. The complete paper is not available online.

Description: Essay states a competing American ideals for the U.S. Health care system include free markets which foster competition, cost effectiveness and quality health care vs.public and private assistance which provides health care independent of a person’s financial means.

Description: Does disease management DM positively influence health care costs? According to three prestigious sources, the answer is no. From Financing Chronic Care Monograph, M-HB05-1.

Description: This paper presents an approach to analyzing continuing care retirement community [CCRC] data, and demonstrates the methods using data from a large CCRC. It is assumed that residents make transitions among a number of states that represent the levels of care required by residents. There is randomness associated with both the transition times and the states entered at these times. The model is conveniently characterized in terms of transition intensity functions, which represent the instantaneous rates of transition between pairs of states.

Description: This is the abstract for the paper, The Cost and Benefits of Treating Type 2 Diabetes Mellitus as a Chronic Condition by Robert D. Lieberthal.