Description: This paper describes seven methods used in care management in the order of their historical development: 1. Pre-Authorization 2. Concurrent Review 3. Case Management 4. Demand Management 5. Disease Management 6. Specialty Case Management 7. Population Health Management Paper 1 of a 8 paper series

Description: This project shows how to use agent-based models to simulate the behaviors of agents in complex health systems.

Description: This paper is being produced in conjunction with eight companion pieces reflecting a variety of stakeholder experiences with the development of the risk pool.

Description: This paper presents a method involving re-sampling 'with replacement but without random numbers', numerical convolutions for sums and quotients, and estimation of confidence intervals for trend in average size claim. In this paper, this method is applied to major medical claims.

Description: This paper provides a description of a method that one can use to develop an estimate of accident year incurred losses if the only available data is aggregate paid losses by calendar year for a number of calendar years. An exhibit demonstrating the use of this method follows this description. From Actuarial Research Clearing House 1993, VOL. 3.

Description: There is some reason to believe that the trend of life companies entering the A & S business will continue. Both the public and the government are becoming increasingly aware of the need and desirability for the widest possible coverage against the loss of income because of disability and against the cost of medical care. This should lead to an expansion of the market for A & S insurance which should attract still other companies to the field in the future. Followed by several discussion papers submitted

Description: This discussion on major medical expense insurance examines the trends in the types of plans sold, popularity of the comprehensive type of medical expense insurance plan, special problems, and dependent coverage. From Transactions of Society of Actuaries 1959, Vol. 11, No. 29 AB.

Description: This paper develops net claim costs for each major type of dental service, using experience data under group dental contracts covering 250,000 persons from 1974-1977. From Transactions of Society of Actuaries 1979, Vol. 31.

Description: This paper explores how change in societal forces can affect the systems for providing security including private pensions, social security, life insurance and health insurance. The societal forces examined are changes in family, role of women, inflation and the age composition of population. From Transactions of Society of Actuaries 1978, Vol. 30.

Description: A divisive confrontation over health care pricing is almost inevitable over the next few years. What will ultimately happen is a political decision, not an actuarial one—but it will have major consequences for the trend in health care costs and the divergence between public and private insurance premiums.