Description: An analysis of the 1999-2011 experience of all Blues plans of betweeen $1.8 and $3.8 billion in annual revenue in 2010 to determine if there is any empirical evidence of an industry underwriting cycle. The analysis shows there is no such evidence.

Description: Diagnostic coding in dental is in its infancy. This article explores the use of medical diagnostic coding and how it may transform dental care in various ways.

Description: It is the purpose of this paper to provide data derived from actual claim experience on lives age 65 and over in a form that will facilitate actuarial calculations involving modification of durations of hospital stay and variations in the allowances provided for miscellaneous services billed by the hospital. From Transactions of Society of Actuaries 1963, Vol. 15, pt. 1, No. 43.

Description: The actuarial committee that authored this report developed a model to estimate the revenue the tax would generate. The results point out key considerations for an excise tax on high cost health plans, including the wide range of results generated by sensitivity to certain assumptions.

Description: A Discussion of why female mortality is higher than male mortality at higher ages.

Description: Part II of a two-part series discussing individual market evolution from before the ACA through President Trump's first term.

Description: This article provides a detailed description of the unbalanced subsidy provisions in the Affordable Care Act with easy to follow numerical illustrations. An understanding of the illustrative calculations is necessary to understand the subsidy implications. The article highlights some surprising and likely unintended results that will be interest to issuers, employers, consumers, regulators and policymakers. Actuaries can add expertise to their clients and to the public discussion with a proper understanding of the subsidy calculations and the resulting implications.

Description: The article discusses the sustainability of the ACA individual market from a public entitlement standpoint. A key point of measuring sustainability is the reliance on market forces rather than federal budget constraints. The article explains why an actuarial viewpoint of sustainability is necessary to a greater extent than other public assistance and social insurance programs. The article challenges actuaries to be a bold, objective voice in a space that is full of opinionated but often uninformed viewpoints.

Description: Discussion of direct primary care and how it helps with several challenges in health care today. DPC improves care coordination, improves outcomes, improves doctor and patient satisfaction, and reduces spending. DPC successes promote the view that primary care should not be covered by insurance; rather, it should be paid for directly.

Description: Presented at October 2000 Annual Meeting. Discusses recent enrollment and cost trends and competitive dynamics with Medicare+Choice capitated plans. Expected future trends are also discussed.