Description: The purpose of this study is to evaluate the predictive accuracy of the commercially available claims-based risk assessment tools under different sets of conditions and with different sets of available information.

Description: Analysis of possible mathematical relationships between hospital quality and hospital billed or allowed charges or other measures, using quality data as defined by the U.S. Department of Health and Human Services along with the Hospital Quality Alliance for their Hospital Quality Initiative.

Description: The principal objective of this paper is to remind actuaries of the rather significant misconceptions and distortions commonly encountered in the use of individual accident and health insurance loss ratios. From Transactions of Society of Actuaries 1979, Vol. 31.

Description: The purpose of this paper is to analyze several existing versions of the return of premium provision and to attempt to develop a logical critique of the concept, with the object of suggesting certain criteria [cost, equity, and compatibility with the purpose of the basic coverage of the health contract] which could serve as a basis for evaluating the merits of various forms of the provision. From Transactions of Society of Actuaries 1970, Vol. 22, Pt. 1, No. 64.

Description: This paper presents research results from a study on health carrier insolvencies. Carriers studies include commercial insurance companies, Blue Cross/Blue Shield pland and health maintenance organizations. From Transactions of Society of Actuaries 1995, Vol. 47.

Description: Research report sponsored by SOA to model and compare projected costs of different proposals for a Medicare prescription drug coverage plan. 3 types of costs are studied: net benefit cost estimates per member per month, continuance table data, and projected annual costs to the government over 10 years for two selected plan designs.

Description: An analysis of prescription drug use in the Kansas individual market