Description: This paper addresses specific details of measurement principles and practice that the actuary should consider when planning to conduct or review a study of care management interventions. Three major topics are covered: Measurement Principles, Study Design Issues, and Risk Factors. Paper 2 of an 8 paper series on 'An Introduction to Care Management Interventions and Their Implications for Actuaries'

Description: Proposes setting premiums such that inflation and age could change the premium over time, rather than prefunding. The value may be to change the approach to pricing LTC and improve the risk.

Description: A review of literature regarding care management program outcomes - either financial or utilization-related which are indicative of financial improvement or from which financial conclusions may be drawn. Includes a discussion on utilization & concurrent review, case & demand & population & disease management . Paper 3 of an 8 paper series on 'An Introduction to Care Management Interventions and Their Implications for Actuaries'.

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: The SOA released a report titled Massachusetts Health Insurance Reform, which looks at the impact on insurance markets, pricing and profitability.

Description: The SOA released a report titled Massachusetts Health Insurance Reform, which looks at the impact on insurance markets, pricing and profitability.

Description: This actuarial memorandum represents the first, formal actuarial opinion regarding the reasonableness of the premium estimates the Clinton Administration presented with its proposed Health Security Act. The memorandum presents the assumptions and methods used to develop an average 1994 premium estimate for the standard benefit package.

Description: This paper applies the principles and methodologies discussed in earlier papers in this series to measure cost savings from a two-year disease management DM program for the 200,000 Medicare members of a regional managed care plan. We then study how savings estimates change when we allow for four variations in key assumptions: methods for identifying or excluding plan members, requirements for eligibility in the health plan, methods for calculating health care trend and study design. Finally, we also examine the sensitivity of these results to product type by comparing the Medicare results to those of the Commercial HMO/POS product. Paper 8 of an 8 paper series titled: “Evaluating the Results of Care Management Interventions: Comparative Analysis of Different Outcomes Measures” sponsored by the Society of Actuaries’ Health Section and the Committee on Knowledge Extension Research.

Description: The Society of Actuaries (SOA) and the LIMRA Secure Retirement Institute are pleased to present the results of new research on the retirement market in China.

Description: Summary of cost-reduction and quality improvement within the disease management sector. Paper 4 of an 8 paper series on 'An Introduction to Care Management Interventions and Their Implications for Actuaries'.